Compounds having RD targeting motifs and methods of use thereof

ABSTRACT

The present invention provides compounds that have motifs that target the compounds to cells that express integrins. In particular, the compounds have peptides with one or more RD motifs conjugated to an agent selected from an imaging agent and a targeting agent. The compounds may be used to detect, monitor and treat a variety of disorders mediated by integrins.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of PCT ApplicationPCT/US2016/030893, filed May 5, 2016, which claims the benefit of U.S.Provisional Application No. 62/157,667, filed May 6, 2015, each of thedisclosures of which is hereby incorporated by reference in itsentirety.

GOVERNMENTAL RIGHTS

This invention was made with government support under CA171651 awardedby the NIH/NCI. The government has certain rights in the invention.

FIELD OF THE INVENTION

The present invention provides compounds that have motifs that targetthe compounds to cells that express integrins. In particular, thecompounds have peptides with one or more RD motifs conjugated to anagent selected from an imaging agent and a targeting agent. Thecompounds may be used to detect, monitor and treat a variety ofdisorders mediated by integrins.

BACKGROUND OF THE INVENTION

Angiogenesis, the formation of new blood vessels, is the cardinalfeature of virtually all malignant tumors and because of itscommonality, probing tumor-induced angiogenesis and associated proteinsis a viable approach to detect and treat a wide range of cancers.Angiogenesis is stimulated by integrins, a large family of transmembraneproteins that mediate dynamic linkages between extracellular adhesionmolecules and the intracellular actin skeleton. Integrins are composedof two different subunits, α and β, which are non-covalently bound intoαβ complexes. Particularly, the expression of α_(v)β₃ integrin (ABI) intumor cells undergoing angiogenesis and on the epithelium oftumor-induced neovasculature alters the interaction of cells with theextracellular matrix, thereby increasing tumorigenicity and invasivenessof cancers.

Numerous studies have shown that ABI and more than 7 other heterodimericintegrins recognize proteins and low molecular weight ligands containingRGD (arginine-glycine-aspartic acid) motifs in proteins and smallpeptides. Based on structural and bioactivity considerations, cyclic RGDpeptide ligands are preferred as delivery vehicles of molecular probesfor imaging and treating ABI-positive tumors and proliferating bloodvessels. Until recently, most of the in vivo imaging studies wereperformed with radiopharmaceuticals because of the high sensitivity andclinical utility of nuclear imaging methods. Particularly, the use ofsmall monoatomic radioisotopes does not generally interfere with thebiodistribution and bioactivity of ligands. Therefore, once a highaffinity ligand for a target receptor is identified, the radiolabeledanalogue is typically used to monitor the activity, pharmacokinetics andpharmacodynamics of the drug or imaging agent. Despite these advantages,nuclear imaging is currently performed in specialized centers because ofregulatory, production and handling issues associated withradiopharmaceuticals. Optical imaging is an alternative, butcomplementary method to interrogate molecular processes in vivo and invitro.

Optical imaging for biomedical applications typically relies onactivating chromophore systems with low energy radiation between 400 and1500 nm wavelengths and monitoring the propagation of light in deeptissues with a charge-coupled device (CCD) camera or other point sourcedetectors. Molecular optical imaging of diseases with molecular probesis attractive because of the flexibility to alter the detectablespectral properties of the beacons, especially in the fluorescencedetection mode. The probes can be designed to target cellular andmolecular processes at functional physiological concentrations. For deeptissue imaging, molecular probes that are photoactive in the nearinfrared (NIR) instead of visible wavelengths are preferred to minimizebackground tissue autofluorescence and light attenuation caused byabsorption by intrinsic chromophores. In contrast to radioisotopes, theNIR antennas are usually large heteroatomic molecules that could impactthe biodistribution and activity of conjugated bioactive ligands.However, previous studies have shown that conjugating small peptidecarriers with NIR molecular probes successfully delivered the beacons totarget proteins in vivo, and the nonspecific distribution of theconjugate in non-target tissues can be minimized by adjusting the netlipophilicity and ionic character of the conjugate.

A need, however, exists for additional compounds that can target andmonitor integrin expression. In particular, a need exists for compoundsthat can target, monitor and/or treat a variety of integrin-mediateddisorders.

SUMMARY OF THE INVENTION

In an aspect, the disclosure provides a compound having the formula:R¹—[X¹ _(m)—R-D-X² _(p)]_(n)—Y—R²

wherein:

-   -   R¹ is a carbocyanine dye or derivative thereof;    -   R² is selected from the group consisting of a treatment agent,        hydrogen, hydroxyl, NH₂, hydrocarbyl, and substituted        hydrocarbyl;    -   X¹ _(m)—R-D-X² _(p) together form a linear or cyclic peptide;    -   X¹ and X² are independently selected from any amino acid        residue;    -   m is an integer from 1 to about 10;    -   n is an integer from 1 to about 10;    -   p is an integer from 1 to about 10; and    -   a dash (-) represent a covalent bond.

In another aspect, the disclosure provides a compound having formula(II):

wherein:

R³ is selected from the group consisting of nanoparticles, small organicmolecules, peptides, organometallics, metal chelates, proteins, drugs,antibiotics, and carbohydrates; and

R⁴ is [X¹ _(m)—R-D-X² _(p)]_(n)—Y—R², wherein:

-   -   R² is independently selected from the group consisting of a        hydrogen, hydroxyl, NH₂, hydrocarbyl, and substituted        hydrocarbyl;    -   X¹ and X² are independently selected from any amino acid        residue;    -   X¹ _(m)—R-D-X² _(p) together form a linear or cyclic peptide;    -   m is an integer from 1 to about 10;    -   n is an integer from 1 to about 10;    -   p is an integer from 1 to about 10; and    -   a dash (-) represent a covalent bond.

In still another aspect, the disclosure provides a compound havingformula (II):

wherein:

R³ is selected from the group consisting of nanoparticles, small organicmolecules, peptides, organometallics, metal chelates, proteins, drugs,antibiotics, and carbohydrates; and

R⁴ is selected from the group consisting of:

SEQ  ID NO: R⁴  8 CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr-OH  9CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 10CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys-OH 11CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 12CONH-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 13CONH-[Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 14CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 15CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 17CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr- OH 18CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- OH 19CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 20CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 21CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 22CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 23CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr- OH

In still yet another aspect, the disclosure provides a method fordetecting expression of a β3 subunit of integrin in a cell, the methodcomprising: (a) contacting a population of cells with a compound of thedisclosure; and detecting the presence of a signal emitted from thecarbocyanine dye of the compound of the disclosure in the population ofcells, the signal being emitted from a cell expressing a β3 subunit ofintegrin.

In a different aspect, the disclosure provides a method for detectingcancer, the method comprising: (a) administering a compositioncomprising an effective amount of a compound of the disclosure to asubject; and (b) detecting the presence of a signal emitted from thecarbocyanine dye of the compound of the disclosure in the subject,wherein detection of signal above baseline indicates cancer.

In other aspects, the disclosure provides a method for detectingpancreatic cancer, the method comprising: (a) administering acomposition comprising an effective amount of a compound of thedisclosure to a subject; and (b) detecting the presence of a signalemitted from the carbocyanine dye of the compound of the disclosure inthe subject, wherein detection of signal above baseline indicatespancreatic cancer.

In yet other aspects, the disclosure provides a method for detectingearly stage pancreatic ductal adenocarcinoma (PDAC) or precursorpancreatic intraepithelial neoplasia (PanIN), the method comprising: (a)administering a composition comprising an effective amount of a compoundof the disclosure to a subject; and (b) detecting the presence of asignal emitted from the carbocyanine dye of the compound of thedisclosure in the subject, wherein detection of signal above baselineindicates early stage pancreatic ductal adenocarcinoma (PDAC) orprecursor pancreatic intraepithelial neoplasia (PanIN).

In still yet other aspects, the disclosure provides a method fordifferentiating pancreatic ductal adenocarcinoma (PDAC) and precursorpancreatic intraepithelial neoplasia (PanIN) from pancreatitis, themethod comprising: (a) administering a composition comprising aneffective amount of a compound of the disclosure to a subject; and (b)detecting the presence of a signal emitted from the carbocyanine dye ofthe compound of the disclosure in the subject, wherein detection ofsignal above baseline indicates PDAC or PanIN and detection of a signalat or below baseline indicates pancreatitis.

In certain aspects, the disclosure provides a method for differentiatingpancreatic ductal adenocarcinoma (PDAC) and PanIN-3 from PanIN-1/2 andductal hyperplasia/metaplasia, the method comprising: (a) administeringa composition comprising an effective amount of a compound of thedisclosure to a subject; and (b) detecting the presence of a signalemitted from the carbocyanine dye of the compound of the disclosure inthe subject, wherein detection of signal above baseline indicates PDACor PanIN-3 and detection of a signal at or below baseline indicatesPanIN-1/2 or ductal hyperplasia/metaplasia.

BRIEF DESCRIPTION OF THE FIGURES

The application file contains at least one drawing executed in color.Copies of this patent application publication with color drawing(s) willbe provided by the Office upon request and payment of the necessary fee.

FIG. 1 depicts the structure of LS838.

FIG. 2A, FIG. 2B, FIG. 2C and FIG. 2D depict the structures of NIR dyeswith different hydrophobicity. (FIG. 2A) LS288; (FIG. 2B) LS798; (FIG.2C) LS276; and (FIG. 2D) LS843.

FIG. 3A, FIG. 3B and FIG. 3C depict the structure of cypates. (FIG. 3A)Cypate (cypate 4); (FIG. 3B) Cypate 3; and (FIG. 3C) Cypate 2.

FIG. 4A, FIG. 4B and FIG. 4C depict the absorption and emission spectraof cypates. (FIG. 4A) Cypate4; (FIG. 4B) Cypate3; (FIG. 4C) Cypate2.

FIG. 5 depicts images showing LS838 for fluorescence and nuclear (PETand or SPECT) imaging. 4T1 luc in Balb/c; 100 μl of 50 μM LS838.

FIG. 6 depicts the distribution of LS838 in tissue at 24 hours.

FIG. 7A, FIG. 7B and FIG. 7C depict structures of molecular imagingagents. (FIG. 7A) (1) ICG: R₁═R₂═SO₃; (2) Cypate: R₁═R₂═CO₂H; (3) LS838:R₁═CO₂H; R₂═CONH-cyclo-(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr-OH (SEQ IDNO:9). (FIG. 7B) LS276; (FIG. 7C) LS288.

FIG. 8A and FIG. 8B depict uptake of LS838 in 4T1 luc cells showinginternalization of the probe in the cells at 1 h (FIG. 8A) and 4 h (FIG.8B) post incubation. Most cells show localization in the lysosomes atearly time points, but the punctate fluorescence became more diffuse at24 h, indicating translocation to the cytosol. Uptake in themitochondria was negligible. Color scheme: cyan, Mitotracker; green,lysotracker; and red, LS838. (FIG. 8C) Internalization of LS838 in cellswas inhibited by Filipinin, an inhibitor of albumin endocytosis via thegp60 pathway. A similar inhibition was observed when Alexa-680 dyelabeled albumin (BSA; blue) was mixed with LS838.

FIG. 9A, FIG. 9B, FIG. 9C, FIG. 9D and FIG. 9E depict noninvasive FMT(top), corresponding ex vivo (middle), and side-view of the pancreasfrom planar fluorescence imaging of pancreatic lesions in mouse models(bottom). FIG. 9A, Advanced KPC; FIG. 9B, 1 week PDAC; FIG. 9C, 2 weeksPDAC; FIG. 9D, pancreatitis; and FIG. 9E, sham surgery using orthotopicMatrigel implant demonstrated selective uptake of LS838 in PDAC, but notin non-tumor controls. The reconstructed yield is superimposed with thecorresponding CT data 10 mm below from the dorsal side. Dotted redcircles: PDAC; solid red circles in C: positive nodules indicated bywhite arrow.

FIG. 10A, FIG. 10B, FIG. 10C, FIG. 10D and FIG. 10E depict H&E staining(left) and corresponding immune-fluorescence (right) of pancreatictissues from FIG. 9 after noninvasive in vivo imaging studies. FIG. 10A,1 week after orthotopic PDAC implant; FIG. 10B, 2-week orthotopic PDACimplant; FIG. 10C, advanced spontaneous KPC model showing highfluorescence uptake in tumor tissue; FIG. 10D, chronic pancreatitisshowing low fluorescence overall but significant fluorescence in regionssuspected to progress toward malignancy; probably PanIN-3; FIG. 10E,sham surgery demonstrating minimal LS838 fluorescence.

FIG. 11A depicts representative flow cytometry plots pre-gated for eachcell type depicted. Cells are derived from established PDAC tumorstreated with LS838. FIG. 11B, Tumor-derived mCherry signal is shown intumor-infiltrating macrophages.

FIG. 12A and FIG. 12B depict laparoscopy of the pancreas and pancreaticlesions using different animal models and controls.

FIG. 13 depicts further derivatization of compounds for drug delivery.The alkyne group can react with any azido group selectively. We envisageusing this molecular as a versatile reagent to incorporate drugs andother biologically active molecules. The method can also be used tointroduce stable radio-halogens.

DETAILED DESCRIPTION OF THE INVENTION

It has been discovered, as detailed in the examples, that a compoundcomprising a peptide having a RD motif and a tyrosine that is notadjacent to an imaging agent targets to a cell that expresses integrins.Unexpectedly, a peptide comprising a tyrosine non-adjacent to acarbocyanine dye conferred enhanced brightness relative to the samepeptide without a tyrosine. Further, a peptide comprising a tyrosineadjacent to a carbocyanine dye resulted in a compound that was rapidlylost and was not retained in the tumor. Thus, the presence and locationof the tyrosine is an essential feature of a compound of the disclosurethat unexpectedly improves the properties of the carbocyanine dyecomprising the peptide.

The present invention, accordingly, provides compounds that may be usedto detect, monitor, and treat a variety of integrin-mediated biologicalprocesses, including the progression of disease states such as diabetes,cardiovascular disease, inflammation and cancer. Specifically a compoundof the invention may be used in pancreatic cancer, for example to detectsmall or microscopic disease as well as differentiate between pancreaticcancer and pancreatitis.

I. Compounds

The compounds of the invention typically comprise at least one linear orcyclic peptide conjugated to an imaging agent and, optionally, atreatment agent, wherein the peptide comprises an RD motif and atyrosine non-adjacent to the imaging agent. The peptide may beconjugated to the imaging agent and/or treatment agent directly by acovalent bond. Alternatively, the peptide may be conjugated to theimaging agent and/or treatment agent by a linker. Suitable linkers aredescribed below. In a specific embodiment, the imaging agent is acarbocyanine dye.

(a) Peptide Regions of the Compound

Generally, the peptide portion of the compound minimally has a size thatincludes at least one RD motif and a tyrosine that is non-adjacent to animaging agent. In an alternative embodiment, the peptide portion of thecompound minimally has a size that includes at least one RGD motif and atyrosine that is non-adjacent to an imaging agent. In some embodiments,the peptide may be linear. In other embodiments, the peptide may becyclic. Typically, the peptide will have from about 3 to about 50 aminoacid residues. In another embodiment, the peptide will have from about 3to about 30 amino acid residues. In a further embodiment, the peptidewill have from about 3 to about 20 amino acid residues. In yet anotherembodiment, the peptide will have from about 3 to about 15 amino acidresidues. In still another embodiment, the peptide will have from about4 to about 12 amino acid residues. In a further embodiment, the peptidewill have from about 4 to about 8 amino acid residues. In a specificembodiment, the peptide will have from about 8 to about 10 amino acidresidues. In another embodiment, the peptide will have 4 amino acidresidues. In an additional embodiment, the peptide will have 5 aminoacid residues. In still another embodiment, the peptide will have 6amino acid residues. In an additional embodiment, the peptide will have7 amino acid residues. In yet another embodiment, the peptide will have8 amino acid residues. In a different embodiment, the peptide will have9 amino acid residues. In other embodiments, the peptide will have 10amino acid residues. In each of the aforementioned embodiments, thepeptide, irrespective of its length, has at least one RD motif and atyrosine that is not adjacent to an imaging agent. It will beappreciated by the skilled artisan that it is possible and, dependingupon the embodiment, it may be desirable to have more than one RD motifor RGD motif within a peptide. For example, it is envisioned, dependingupon the length of the peptide, that there may be from 2 to about 5 RDmotifs or RGD motifs in a given peptide.

The choice of amino acid residues, in addition to the RD motif or RGDmotif, that will comprise the peptide will vary greatly depending uponthe particular application for the compound. For example, it may bedesirable in certain imaging or treatment applications that the compoundbe substantially hydrophilic. In other imaging or treatmentapplications, it may be desirable for the compound to be substantiallyhydrophobic. Generally, the amino acids may be selected from any aminoacid residue including hydrophobic amino acids (e.g., L, A, P, V, M, F,W, and I), polar, uncharged amino acids (e.g., G, S, N, Q, T, Y, and C),acidic amino acids (e.g., D and E) and basic amino acids (e.g., K, H,and R). The amino acid residues may also be modified amino acid residuesthat are commonly known in the art. For embodiments in which ahydrophobic compound is desired, typically the amino acid residuescomprising the peptide will be predominantly selected from hydrophobicamino acids. In embodiments in which a hydrophilic compound is desired,typically the amino acid residues comprising the peptide will bepredominantly polar, uncharged or polar, charged amino residues. Anamino acid may be a naturally occurring L-amino acid or a non-naturalD-amino acid. In certain embodiments, the D-amino acid is D-cysteineand/or D-tyrosine. In a specific embodiment, the D-cysteine is linked toan imaging agent. In other specific embodiments, the D-cysteine islinked to a carbocyanine dye. The inventors have shown that theunnatural D-cysteine linked to a carbocyanine dye confers high stabilityon the compound. Without wishing to be bound by theory, it is believedthat this is because of the resistance of the compound to degradation byproteases. In an embodiment, a peptide of the invention is a cyclicpeptide, wherein the peptide comprises two cysteines which cyclize thepeptide by forming a disulfide bridge. In a specific embodiment, apeptide of the invention is a cyclic peptide comprising_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys (SEQ ID NO:24) or_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys (SEQ ID NO:25). Following the cyclicpeptide, the peptide further comprises a tyrosine (Tyr). The Tyr residueunexpectedly increases the brightness of the compound such that smalleramounts are needed. Further, the location of the Tyr residue isimportant, as it was discovered that positioning the Tyr next to thecarbocyanine dye led to rapid loss of retention of the compound in vivo.In a specific embodiment, a peptide of the invention may compriseCyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr (SEQ ID NO:9).

Further, the peptide may comprise additional amino acids before and/orafter the cyclic peptide and tyrosine. For example, the peptide maycomprise 1, 2, 3, 4, or 5 amino acids prior to the cyclic peptide.Additionally, the peptide may comprise 1, 2, 3, 4, or 5 amino acidsafter the Tyr. Non-limiting examples of peptides for use in a compoundof the disclosure include those listed in Table A. In a specificembodiment, a peptide for use in a compound may be selected from thepeptides of Table A.

TABLE A SEQ ID NO: Peptide  8 _(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-Lys-Tyr  9_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-Tyr 10_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-Tyr-Lys 11_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys-Tyr 12Cys-Gly-Arg-Asp-Ser-Pro-Cys-Tyr 13 Cys-Arg-Gly-Asp-Ser-Pro-Cys-Tyr 14_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys-Tyr 15_(D)Cys-Arg-Gly-Asp-Ser-Pro-_(D)Cys-Tyr 17Gly-_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-Tyr 18Gly-_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-_(D)Tyr 19Gly-_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys-_(D)Tyr-Lys 20Gly-Cys-Gly-Arg-Asp-Ser-Pro-Cys-_(D)Tyr-Lys 21Gly-_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys-Tyr 22Gly-Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys-Tyr 23Gly-_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys-_(D)Tyr

In an alternative embodiment, the compound may have more than onepeptide having a RD motif or RGD motif with the size (i.e., number ofamino acid residues) and amino acid composition detailed above. Forapplications involving more than one peptide, the individual peptidesmay form a single continuous chain with each individual peptide attachedtogether either directly by a covalent bond or they may be separated bya linker. The single continuous chain of individual peptides may then beconjugated to the agent either directly via a covalent bond or by alinker. Alternatively, individual peptides may each be conjugateddirectly to the agent by either a covalent bond or by a linker. Thenumber of individual peptides can and will vary. Typically, there may befrom about 1 to about 15 peptides having a RD motif or RGD motif. Inanother embodiment, there may be from about 1 to about 12 peptides. In afurther embodiment, there may be from about 1 to about 10 peptides. Inyet another embodiment, there may be from about 1 to about 5 peptides.In a further embodiment, there is one peptide. In yet anotherembodiment, there are two peptides. In an additional embodiment, thereare 3 peptides. In an additional embodiment, there are 4 peptides. Instill another embodiment, there are 5 peptides.

(b) Imaging Agents and Treatment Agents

The compound of the invention includes at least one imaging agent and,optionally, a treatment agent. In one embodiment, the compound maycomprise an imaging agent. In an alternative embodiment, the compoundmay comprise an imaging agent and a treatment agent. Irrespective of theembodiment, the agent(s) may be either conjugated to the compound by acovalent bond or conjugated via a linker.

Several imaging agents are suitable for use to the extent that theyprovide the ability to detect or monitor the localization of thecompound(s) of the present invention. In one embodiment, the imagingagent comprises an optical imaging agent. Optical imaging agentssuitable for use in the invention can and will vary depending on theembodiment, but include fluorophores, organic fluorescent dyes,luminescent imaging agents, fluorescent lanthanide complexes, andfluorescent semiconductor nanocrystals. Examples of suitable visible(400-700 nm) fluorescent dyes include fluorescein, FITC, rhodamine,Texas Red, CyDyes (e.g., Cy3, Cy5, Cy5.5), Alexa Fluors (e.g., Alexa⁴⁸⁸,Alexa⁵⁵⁵, Alexa⁵⁹⁴; Alexa⁶⁴⁷) and DyDelight Dyes. Examples of suitablenear infrared (NIR) (700-900 nm) fluorescent dyes include carbocyaninedyes, such as cypate and its derivatives. Luminescence imaging agentsinclude luminescent lanthanide chelates and bioluminescence compounds(e.g., bacterial Lux, eukaryotic Luc or Ruc systems). In a specificembodiment, an imaging agent is a carbocyanine dye or a derivativethereof. Suitable carbocyanine dyes are known in the art or as describedin the Examples. Non-limiting examples of carbocyanine dyes includethose depicted in FIG. 1, FIG. 2A, FIG. 2B, FIG. 2C, FIG. 2D, FIG. 3A,FIG. 3B, FIG. 3C, FIG. 7A, FIG. 7B, FIG. 7C, and FIG. 13. In a specificembodiment, a compound of the disclosure comprises a carbocyanine dyeselected from those depicted in FIG. 1, FIG. 2A, FIG. 2B, FIG. 2C, FIG.2D, FIG. 3A, FIG. 3B, FIG. 3C, FIG. 7A, FIG. 7B, FIG. 7C, and FIG. 13.In another specific embodiment, a compound of the disclosure comprises acarbocyanine dye selected from the group consisting of Cypate (cypate4), LS288, LS798, LS276, LS843, Cypate 3, and Cypate 2. A derivative ofa carbocyanine dye may comprise a nonionic group (i.e. polyethyleneglycol) or a positively charged moiety (i.e. ⁺NMe₃) conjugated to a freecarboxylic acid group of a cypate. Alternatively, a derivative of acarbocyanine dye may comprise a functional group for conjugation of aradioisotope, treatment agent or other biologically active molecule.Non-limiting examples of biologically active molecules includenanoparticles, small organic molecules, peptides, proteins,organometallics, drugs, antibiotics, and carbohydrates. In certainembodiments, the biologically active molecule is <500 Da. Exemplaryfunctional groups are depicted in Table 4 and FIG. 13. In a specificembodiment, a functional group is selected from the group consisting ofan alkyne, azido (N₃), and a chelating agent. As used herein, a“chelating agent” is a molecule that forms multiple chemical bonds witha single metal atom. Examples of chelating agents include, but are notlimited to, iminodicarboxylic and polyaminopolycarboxylic reactivegroups, diethylenetriaminepentaacetic acid (DTPA),1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA),tetramethyl heptanedionate (TMHD), 2,4-pentanedione,ethylenediamine-tetraacetic acid disodium salt (EDTA),ethyleneglycol-O,O′-bis(2-aminoethyl)-N, N, N′, N′-tetraacetic acid(EGTA), N-(2-hydroxyethyl)ethylenediamine-N,N′,N′-triacetic acidtrisodium salt (HEDTA), nitrilotriacetic acid (NTA), and1,4,8,11-tetraazacyclotetradecane-N,N′,N″,N′″-tetraacetic acid (TETA),deferoxamine (DFO), and derivatives thereof. A radioisotope, treatmentagent and biologically active molecule are described below.

In an alternative embodiment, the imaging agent is a radiologicalimaging agent. In certain embodiments, a compound of the inventioncomprises two imaging agents: a carbocyanine dye or derivative thereofand a radioisotope. The radioisotope may be conjugated to thecarbocyanine dye or may be conjugated to the Tyr of the peptide. Avariety of radioisotopes that are capable of being detected, such as ina PET or SPECT diagnostic imaging procedure, are suitable for use in thepresent invention. Suitable examples of radiological imaging agentsinclude Antimony-124, Antimony-125, Arsenic-74, Barium-103, Barium-140,Beryllium-7, Bismuth-206, Bismuth-207, Cadmium-109, Cadium-115,Calcium-45, Cerium-139, Cerium-141, Cerium-144, Cesium-137, Chromium-51,Gadolinium-153, Gold-195, Gold-199, Hafnium-175-181, Indium-111,Iridium-192, Iron-55, Iron-59, Krypton-85, Lead-210, Manganese-54,Mercury-197, Mercury-203, Molybdenum-99, Neodymium-147, Neptunium-237,Nickel-63, Niobium-95, Osmium-185, Palladium-103, Platinum-195,Praseodymium-143, Promethium-147, Protactinium-233, Radium-226,Rhenium-186, Rubidium-86, Ruthenium-103, Ruthenium-106, Scandium-44,Scandium-46, Selenium-75, Silver-110, Silver-111, Sodium-22,Strontium-85, Strontium-89, Strontium-90, Sulfur-35, Tantalum-182,Technetium-99, Tellurium-125, Tellurium-132, Thallium-204, Thorium-228,Thorium-232, Thallium-170, Tin-113, Titanium-44, Tungsten-185,Vanadium-48, Vanadium-49, Ytterbium-169, Yttrium-88, Yttrium-90,Yttrium-91, Zinc-65, and Zirconium. In a further alternative embodiment,the radiological imaging agent is selected from the group consisting ofTechnecium-99, Indium-111, Strontium-90, Iodine-125, Thallium-201,fluorine-18, carbon-11, carbon-13, nitrogen-13, Oxygen-15, Copper-64,Lutetium-177, Yttrium-90, and Iodine-123, Iodine-124, Iodine-125, andIodine-131. In certain embodiments, a radioisotope may be used as animaging agent and as a treatment agent. It is known in the art whichradioisotopes function as both imaging agents and treatment agents. Forexample, since Iodine-131 has both a beta and gamma decay mode, it canbe used for radiotherapy or for imaging.

A variety of other imaging agents are suitable for use in the invention.For example, other imaging agents include, gadolinium,metalloporphyrins, ferric chloride, ferric ammonium citrate, andferrioxamine methanesulfonate for magnetic resonance imaging.

An imaging agent emits a signal that can be detected by a signaltransducing machine. In some cases, imaging agent can emit a signalspontaneously, such as when the detectable label is a radionuclide. Inother cases the imaging agent emits a signal as a result of beingstimulated by an external field such as when the imaging agent is arelaxivity metal. Examples of signals include, without limitation, gammarays, X-rays, visible light, infrared energy, and radiowaves.Non-limiting examples of modalities of imaging may include magneticresonance imaging (MRI), ultrasound (US), computed tomography (CT),Positron Emission Tomography (PET), Single Photon Emission ComputedTomography (SPECT), and optical imaging (01, bioluminescence andfluorescence).

The compound of the invention optionally includes one or more treatmentagents, such as a drug or hormone. In certain embodiments, a compound ofthe invention comprises an imaging agent and a treatment agent. In otherembodiments, a compound of the invention comprises a carbocyanine dye orderivative thereof and a treatment agent. As will be appreciated by theskilled artisan, the choice of a particular treatment agent can and willvary depending upon the indication to be treated and its stage ofprogression. Because the compounds of the invention are selectivelytargeted to cells that express integrins, the treatment agents aregenerally directed toward treatment of an intregrin-mediated disordersuch as diabetes, inflammation, cardiovascular disease, and cancer. Forexample, when the indication is diabetes, the treatment agent may besulfonylureas, biguanides, thiazolidinediones, meglitinides,D-phenylalanine derivatives, amylin synthetic derivatives, and incretinmimetics. In a further embodiment, when the indication is inflammation,the treatment agent may be an NSAID such as aniline derivatives(acetaminophen), indole-3-acetic acid derivatives (indomethacin),specific Cox-2 inhibitors (Celebrex), and aspirin. By way of furtherexample, when the indication is cardiovascular disease, the treatmentagent may include sodium-channel blockers (e.g., quinidine),beta-blockers (e.g., propranolol), calcium-channel blockers (e.g.,diltiazen), diuretics (e.g., hydrochlorothiazide), ACE inhibitors (e.g.,captopril), and thrombolytic agents (e.g., tissue plasminogen activatorand streptokinase). In an additional embodiment when the indication iscancer, the treatment agent may include DNA synthesis inhibitors (e.g.,daunorubicin, and adriamycin), mitotic inhibitors (e.g., the taxanes,paclitaxel, and docetaxel), the vinca alkaloids (e.g., vinblastine,vincristine, and vinorelbine), antimetabolites (e.g., 5-fluorouracil,capecitabine, 6-mercaptopurine, methotrexate, gemcitabine, cytarabine(ara-C), fludarabine, pemetrexed, cytosine arabinoside, methotrexate,and aminopterin), alkylating agents (e.g., busulfan, cisplatin,carboplatin, chlorambucil, cyclophosphamide, ifosfamide, dacarbazine(DTIC), mechlorethamine (nitrogen mustard), melphalan, andtemozolomide), nitrosoureas (e.g., carmustine (BCNU) and lomustine(CCNU) anthracyclines (e.g., daunorubicin, doxorubicin (Adriamycin),epirubicin, idarubicin, and mitoxantrone), topoisomerase inhibitors(e.g., topotecan, irinotecan, etoposide (VP-16), and teniposide),cytotoxins (e.g., paclitaxel, vinblastine, and macromycin),anti-cytoskeletals (e.g., taxol and cholchicine) and angiogenesisinhibitors (e.g., VEGF inhibitors, anti-VEGF Abs). Summaries of cancerdrugs, including information regarding approved indications, may befound via the National Cancer Institute at the National Institutes ofHealth, the FDA Approved Drug Product database and the NationalComprehensive Cancer Network (NCCN) guidelines. In a specificembodiment, a treatment agent may be a chemotherapeutic. In anotherspecific embodiment, a treatment agent may be a chemotherapeutic forpancreatic cancer. Other suitable treatment agents may include hormones(e.g., steroids), antibodies, antibody fragments, peptides,glycopeptides, peptidomimetic, drug mimic, metal chelating agents,radioactive agents, echogenic agents, various drugs (in addition to theones specifically delineated), antisense molecules, and small inhibitoryRNAs.

(c) Linkers

In certain embodiments, the imaging agent and/or treatment agent isconjugated to the linear peptide via one or more linkers. In otherembodiments having more than one linear peptide or one or more cyclicpeptides, the individual peptides may optionally be conjugated via oneor more linkers.

A variety of linkers are suitable in the present invention, buttypically the linker will impart a degree of flexibility to the compoundof the invention. Generally speaking, the chain of atoms defining thelinker can and will vary depending upon the embodiment. In certainembodiment, the linker will comprise one or more amino acids. Amino acidresidue linkers are usually at least one residue and can be 50 or moreresidues. In an embodiment, a linker may be about 1 to about 10 aminoacids. In another embodiment, a linker may be about 10 to about 20 aminoacids. In still another embodiment, a linker may be about 20 to about 30amino acids. In still yet another embodiment, a linker may be about 30to about 40 amino acids. In different embodiments, a linker may be about40 to about 50 amino acids. In other embodiments, a linker may be morethan 50 amino acids. For instance, a linker may be 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25,26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43,44, 45, 46, 47, 48, 49 or 50 amino acids. In a specific embodiment, alinker is 1 amino acid.

Any amino acid residue may be used for the linker. Typical amino acidresidues used for linking are glycine, serine, alanine, leucine, lysine,glutamic and aspartic acid, or the like. For example, a linker may be(AAS)_(n), (AAAL)_(n), (G_(n)S)_(n) or (G₂S)_(n), wherein A is alanine,S is serine, L is leucine, and G is glycine and wherein n is an integerfrom 1-20, or 1-10, or 3-10. Accordingly, n may be 1, 2, 3, 4, 5, 6, 7,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20. Thus, in certainembodiments, a linker includes, but is not limited to, (AAS)_(n),(AAAL)_(n), (G_(n)S)_(n) or (G₂S)_(n), wherein A is alanine, S isserine, L is leucine, and G is glycine and wherein n is an integer from1-20, or 1-10, or 3-10. In a specific embodiment, a linker is oneglycine.

In a further embodiment, the linker will comprise hydrocarbyl orsubstituted hydrocarbyl groups. In a typical alternative of thisembodiment, the linker is from about 1 to about 50 atoms in length.Alternatively, the linker is from about 2 about 30 atoms in length. Inan embodiment, the linker is from about 4 to about 20 atoms in length.The linker may comprise a variety of heteroatoms that may be saturatedor unsaturated, substituted or unsubstituted, linear or cyclic, orstraight or branched. The chain of atoms defining the linker willtypically be selected from the group consisting of carbon, oxygen,nitrogen, sulfur, selenium, silicon and phosphorous. In an alternativeembodiment, the chain of atoms is selected from the group consisting ofcarbon, oxygen, nitrogen, sulfur and selenium. In an embodiment, thelinker will comprise substantially carbon and oxygen atoms. In addition,the chain of atoms defining the linker may be substituted orunsubstituted with atoms other than hydrogen, including, but not limitedto, hydroxy, keto (═O), or acyl, such as acetyl. Thus, the chain mayoptionally include one or more ether, thioether, selenoether, amide, oramine linkages between hydrocarbyl or substituted hydrocarbyl regions.Exemplary linkers include ethylene glycol and aminohexanoic acid. Morespecifically, a linker may be a polyethylene glycol linker. Such alinker may be referred to as a heterobifunctional PEG linker or ahomobifunctional PEG linker.

In certain embodiments, a linker further comprises one or more spacers.Spacers are known in the art. Non-limiting examples of spacers include2-aminoethoxy-2-ethoxy acetic acid (AEEA) linkers, AEEEA linkers, andAEA linkers. In a specific embodiment, a linker further comprises one ormore 2-aminoethoxy-2-ethoxy acetic acid (AEEA) linkers.

(d) Exemplary Compounds of the Invention

In one exemplary embodiment, the compound will have the characteristicsdetailed above and will be defined by formula (I):R¹—[X¹ _(m)—R-D-X² _(p)]_(n)—Y—R²  (I)

wherein:

-   -   R¹ is an imaging agent;    -   R² is independently selected from the group consisting of a        treatment agent, hydrogen, hydroxyl, NH₂, hydrocarbyl, and        substituted hydrocarbyl;    -   X¹ and X² are independently selected from any amino acid        residue;    -   X¹ _(m)—R-D-X² _(p) together form a linear or cyclic peptide;    -   m is an integer from 1 to about 10;    -   n is an integer from 1 to about 10;    -   p is an integer from 1 to about 10; and    -   a dash (-) represent a covalent bond.

In an alternative embodiment, the compound will have formula (I)wherein:

-   -   n is from 1 to 5;    -   m is from 1 to 3;    -   p is from 1 to 3; and    -   X¹ and X² are selected from the group consisting of C, G, S, P,        C, N, Q, D, E, K, R, T and H.

In a specific embodiment, X¹ is CG; m is 1; X² is SPC; p is 1; and nis 1. In another specific embodiment, the C of X¹ is D-cysteine and/orthe C of X² is D-cysteine. In still another specific embodiment, the Yis D-tyrosine.

In certain embodiments, a cyclic peptide is [CGRDSPC] (SEQ ID NO:24),wherein the two cysteines cyclize the peptide by forming a disulfidebridge. The cysteines are both L-cysteine, both D-cysteine, or one isL-cysteine and one is D-cysteine. In other embodiments, one or moreamino acid residues are inserted prior to or after the Y. In a specificembodiment, an amino acid residue is inserted after Y. In anotherspecific embodiment, a Lys (K) is inserted after the Y.

In certain embodiments, the Y is halogenated. Halogens include fluorine,chlorine, bromine, iodine, and astatine. More specifically, the halogenis a radioisotope selected from the group consisting of ¹⁸F, ⁷⁵Br, ⁷⁷Br,¹²²I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹²⁹I, ¹³¹I, and ²¹¹At.

In an exemplary embodiment, [X¹ _(m)—R-D-X² _(p)]_(n)—Y is selected fromthe group consisting of:

SEQ ID NO: [X¹ _(m)-R-D-X² _(p)]_(n)Y  8[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr  9[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 10[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys 11[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 12[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 17Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 18Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr 19Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 20Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 21Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 22Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 23Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr

In certain embodiments, R² is selected from the group consisting ofhydroxyl and NH₂. In a specific embodiment, R² is hydroxyl.

In an embodiment, R¹ is a carbocyanine dye or a derivative thereof. Inanother embodiment, R¹ is selected from the group consisting of Cypate(cypate 4), LS288, LS798, LS276, LS843, Cypate 3, and Cypate 2. In aspecific embodiment, a derivative of a carbocyanine dye comprises analkyne, azido (N₃), or a chelating agent. In still another specificembodiment, a derivative of a carbocyanine dye comprises a nanoparticle,a small organic molecule, a peptide, an organometallic, a metal chelate,a protein, a drug, an antibiotic, or a carbohydrate.

In each embodiment for compounds having formula (I), the compound mayoptionally comprise a linker, L¹, that conjugates R¹ to X¹. The compoundmay additionally comprise a linker, L², that conjugates R² to Y. Inaddition, the compound may additionally comprise a linker, L³, thatconjugates R¹ to X². The compound may additionally comprise a linker,L⁴, that conjugates R² to X¹. The compound may additionally comprise alinker, L⁵, that conjugates X¹ to X². Furthermore, the compound mayadditionally comprise a linker, L⁶, that conjugates R¹ to R². In aspecific embodiment, L¹ is glycine. In another specific embodiment, L¹is polyethylene glycol.

In another exemplary embodiment, the compound will have thecharacteristics detailed above and will be defined by formula (II):

wherein:

R³ is selected from the group consisting of nanoparticles, small organicmolecules, peptides, organometallics, metal chelates, proteins, drugs,antibiotics, and carbohydrates; and

R⁴ is [X¹ _(m)—R-D-X² _(p)]_(n)—Y—R², wherein:

-   -   R² is independently selected from the group consisting of a        hydrogen, hydroxyl, NH₂, hydrocarbyl, and substituted        hydrocarbyl;    -   X¹ and X² are independently selected from any amino acid        residue;    -   X¹ _(m)—R-D-X² _(p) together form a linear or cyclic peptide;    -   m is an integer from 1 to about 10;    -   n is an integer from 1 to about 10;    -   p is an integer from 1 to about 10; and    -   a dash (-) represent a covalent bond.

In an alternative embodiment, the compound will have formula (II)wherein:

-   -   n is from 1 to 5;    -   m is from 1 to 3;    -   p is from 1 to 3; and    -   X¹ and X² are selected from the group consisting of C, G, S, P,        C, N, Q, D, E, K, R, T and H.

In a specific embodiment, X¹ is CG; m is 1; X² is SPC; p is 1; and nis 1. In another specific embodiment, the C of X¹ is D-cysteine and/orthe C of X² is D-cysteine. In still another specific embodiment, the Yis D-tyrosine.

In certain embodiments, a cyclic peptide is [CGRDSPC] (SEQ ID NO:24),wherein the two cysteines cyclize the peptide by forming a disulfidebridge. The cysteines are both L-cysteine, both D-cysteine, or one isL-cysteine and one is D-cysteine. In other embodiments, one or moreamino acid residues are inserted prior to or after the Y. In a specificembodiment, an amino acid residue is inserted after Y. In anotherspecific embodiment, a Lys (K) is inserted after the Y.

In certain embodiments, the Y is halogenated. Halogens include fluorine,chlorine, bromine, iodine, and astatine. More specifically, the halogenis a radioisotope selected from the group consisting of ¹⁸F, ⁷⁵Br, ⁷⁷Br,¹²²I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹²⁹I, ¹³¹I, and ²¹¹At.

In an exemplary embodiment, [X¹ _(m)—R-D-X² _(p)]_(n)—Y is selected fromthe group consisting of:

SEQ ID NO: [X¹ _(m)-R-D-X² _(p)]_(n)Y  8[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr  9[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 10[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys 11[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 12[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 17Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 18Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr 19Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 20Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 21Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 22Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 23Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr

In certain embodiments, R² is selected from the group consisting ofhydroxyl and NH₂. In a specific embodiment, R² is hydroxyl.

In other embodiments, the compound will have the characteristicsdetailed above and will be defined by formula (II):

wherein:

R³ is selected from the group consisting of nanoparticles, small organicmolecules, peptides, organometallics, metal chelates, proteins, drugs,antibiotics, and carbohydrates; and

R⁴ is selected from the group consisting of:

SEQ  ID NO: R⁴  8 CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr-OH  9CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 10CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys-OH 11CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 12CONH-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 13CONH-[Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 14CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 15CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 17CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr- OH 18CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- OH 19CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 20CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 21CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 22CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 23CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr- OH

In certain embodiments, the Y is halogenated. Halogens include fluorine,chlorine, bromine, iodine, and astatine. More specifically, the halogenis a radioisotope selected from the group consisting of ¹⁸F, ⁷⁵Br, ⁷⁷Br,¹²²I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹²⁹I, ¹³¹I, and ²¹¹At.

Alternatively, for each embodiment for compounds having formula (I) orformula (II), the compound may optionally comprise at least one cyclicpeptide having a RGD motif. Generally, the cyclic peptide has from about4 amino acid residues to about 10 amino acid residues. In oneembodiment, the cyclic peptide has 5 amino acid residues. In thisembodiment, 3 of the amino acid residues will be the RGD motif and theother two amino acid residues may be selected from any amino acidresidue detailed above. In an alternative embodiment, the cyclic peptidehas 6 amino acid residues. In this embodiment, 3 of the amino acidresidues will be the RGD motif and the other three may be selected fromany amino acid residue detailed above.

In a further exemplary embodiment, the compound will have thecharacteristics detailed above and will be defined by formula (II):R¹—[X¹ _(m)—R-D-X² _(p)]_(n)—R³—[X³ _(q)—R-G-D-X⁴ _(t)]_(n)—Y—R²

wherein:

-   -   R¹ is an imaging agent;    -   R² is independently selected from the group consisting of a        treatment agent, hydrogen, hydroxyl, NH₂, hydrocarbyl, and        substituted hydrocarbyl;    -   R³ is a covalent bond or a linker;    -   X¹, X², X³ and X⁴ are independently selected from any amino acid        residue;    -   X¹ _(m)—R-D-X² _(p) together form a linear or cyclic peptide;    -   X³ _(q)—R-G-D-X⁴ _(t) together form a cyclic peptide;    -   m is an integer from 1 to about 10;    -   n is an integer from 1 to about 10;    -   p is an integer from 1 to about 10;    -   q is an integer from about 1 to 5;    -   s is an integer from about 1 to 10;    -   t is an integer from about 1 to 5; and    -   a dash (-) represent a covalent bond.

In an alternative embodiment, the compound will have formula (II)wherein:

-   -   n is from 1 to 3;    -   m is from 1 to 3;    -   p is from 1 to 3;    -   q is 2 or 3;    -   s is from 1 to 3;    -   t is 2 or 3;    -   X¹ and X² are selected from the group consisting of G, S, N, Q,        D, E, K, R,    -   T, Y, C, P and H; and    -   X³ and X⁴ are selected from any amino acid residue.

In each embodiment for compounds having formula (II), the compound mayoptionally comprise a linker, L¹, that conjugates R¹ to X¹. In addition,the compound may additionally comprise a linker, L², that conjugates R²to Y.

Other exemplary compounds of the invention are illustrated in theExamples.

In addition, the compound(s) of the present invention can exist intautomeric, geometric or stereoisomeric forms. The present inventioncontemplates all such compounds, including cis- and trans-geometricisomers, E- and Z-geometric isomers, R- and S-enantiomers,diastereomers, d-isomers, I-isomers, the racemic mixtures thereof andother mixtures thereof. Pharmaceutically acceptable salts of suchtautomeric, geometric or stereoisomeric forms are also included withinthe invention. The terms “cis” and “trans”, as used herein, denote aform of geometric isomerism in which two carbon atoms connected by adouble bond will each have a hydrogen atom on the same side of thedouble bond (“cis”) or on opposite sides of the double bond (“trans”).Some of the compounds described contain alkenyl groups, and are meant toinclude both cis and trans or “E” and “Z” geometric forms. Furthermore,some of the compounds described contain one or more stereocenters andare meant to include R, S, and mixtures of R and S forms for eachstereocenter present.

In a further embodiment, the compound(s) of the present invention may bein the form of free bases or pharmaceutically acceptable acid additionsalts thereof. The term “pharmaceutically-acceptable salts” are saltscommonly used to form alkali metal salts and to form addition salts offree acids or free bases. The nature of the salt may vary, provided thatit is pharmaceutically acceptable. Suitable pharmaceutically acceptableacid addition salts of compounds for use in the present methods may beprepared from an inorganic acid or from an organic acid. Examples ofsuch inorganic acids are hydrochloric, hydrobromic, hydroiodic, nitric,carbonic, sulfuric and phosphoric acid. Appropriate organic acids may beselected from aliphatic, cycloaliphatic, aromatic, araliphatic,heterocyclic, carboxylic and sulfonic classes of organic acids, examplesof which are formic, acetic, propionic, succinic, glycolic, gluconic,lactic, malic, tartaric, citric, ascorbic, glucuronic, maleic, fumaric,pyruvic, aspartic, glutamic, benzoic, anthranilic, mesylic,4-hydroxybenzoic, phenylacetic, mandelic, embonic (pamoic),methanesulfonic, ethanesulfonic, benzenesulfonic, pantothenic,2-hydroxyethanesulfonic, toluenesulfonic, sulfanilic,cyclohexylaminosulfonic, stearic, algenic, hydroxybutyric, salicylic,galactaric and galacturonic acid. Suitable pharmaceutically-acceptablebase addition salts of compounds of use in the present methods includemetallic salts made from aluminum, calcium, lithium, magnesium,potassium, sodium and zinc or organic salts made from N,N′-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine,ethylenediamine, meglumine-(N-methylglucamine) and procaine.

As will be appreciated by a skilled artisan, the compound(s) of thepresent invention can be administered by a number of different meansthat will deliver an effective dose for either detection or treatmentpurposes. Such compositions can be administered orally, parenterally, byinhalation spray, rectally, intradermally, transdermally, or topicallyin dosage unit formulations containing conventional nontoxicpharmaceutically acceptable carriers, adjuvants, and vehicles asdesired. Topical administration may also involve the use of transdermaladministration such as transdermal patches or iontophoresis devices. Theterm parenteral as used herein includes subcutaneous, intravenous,intramuscular, or intrasternal injection, or infusion techniques.Formulation of drugs is discussed in, for example, Hoover, John E.,Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa.(1975), and Liberman, H. A. and Lachman, L., Eds., Pharmaceutical DosageForms, Marcel Decker, New York, N.Y. (1980).

Injectable preparations, for example, sterile injectable aqueous oroleaginous suspensions, can be formulated according to the known artusing suitable dispersing or wetting agents and suspending agents. Thesterile injectable preparation may also be a sterile injectable solutionor suspension in a nontoxic parenterally acceptable diluent or solvent.Among the acceptable vehicles and solvents that may be employed arewater, Ringer's solution, and isotonic sodium chloride solution. Inaddition, sterile, fixed oils are conventionally employed as a solventor suspending medium. For this purpose, any bland fixed oil may beemployed, including synthetic mono- or diglycerides. In addition, fattyacids such as oleic acid are useful in the preparation of injectables.Dimethyl acetamide, surfactants including ionic and non-ionicdetergents, and polyethylene glycols can be used. Mixtures of solventsand wetting agents such as those discussed above are also useful.

Solid dosage forms for oral administration may include capsules,tablets, pills, powders, and granules. In such solid dosage forms, thecompound is ordinarily combined with one or more adjuvants appropriateto the indicated route of administration. If administered per os, thecompound can be admixed with lactose, sucrose, starch powder, celluloseesters of alkanoic acids, cellulose alkyl esters, talc, stearic acid,magnesium stearate, magnesium oxide, sodium and calcium salts ofphosphoric and sulfuric acids, gelatin, acacia gum, sodium alginate,polyvinylpyrrolidone, and/or polyvinyl alcohol, and then tableted orencapsulated for convenient administration. Such capsules or tablets cancontain a controlled-release formulation as can be provided in adispersion of active compound in hydroxypropylmethyl cellulose. In thecase of capsules, tablets, and pills, the dosage forms can also comprisebuffering agents such as sodium citrate, or magnesium or calciumcarbonate or bicarbonate. Tablets and pills can additionally be preparedwith enteric coatings.

For therapeutic purposes, formulations for parenteral administration canbe in the form of aqueous or non-aqueous isotonic sterile injectionsolutions or suspensions. These solutions and suspensions can beprepared from sterile powders or granules having one or more of thecarriers or diluents mentioned for use in the formulations for oraladministration. The compounds can be dissolved in water, polyethyleneglycol, propylene glycol, ethanol, corn oil, cottonseed oil, peanut oil,sesame oil, benzyl alcohol, sodium chloride, and/or various buffers.Other adjuvants and modes of administration are well and widely known inthe pharmaceutical art.

Liquid dosage forms for oral administration can include pharmaceuticallyacceptable emulsions, solutions, suspensions, syrups, and elixirscontaining inert diluents commonly used in the art, such as water. Suchcompositions can also comprise adjuvants, such as wetting agents,emulsifying and suspending agents, and sweetening, flavoring, andperfuming agents.

II. Methods

The present invention encompasses a method for detecting, monitoringand/or treatment or prevention of a variety of integrin-mediateddisorders in a subject. Specifically, the present invention encompassesa method for detecting a variety of integrin-mediated disorders in asubject.

In an aspect, the present invention encompasses a method for detectingexpression of a β3 subunit of integrin in a cell. The method comprisescontacting a population of cells with a compound of the invention anddetecting the presence of a signal emitted from the imaging agent of thecompound of the invention in the population of cells, the signal beingemitted from a cell expressing a β3 subunit of integrin.

In another aspect, the present invention encompasses a method fordetecting, monitoring and/or treatment or prevention of cancer. Themethod comprises administering an effective amount of a compositioncomprising a compound of the invention to a subject; and detecting thepresence of a signal emitted from the imaging agent of the compound ofthe invention in the subject, wherein detection of signal above baselineindicates cancer. In a specific embodiment, the present inventionencompasses a method for detecting cancer in a subject.

In still another aspect, the present invention encompasses a method fordetecting, monitoring and/or treatment or prevention of pancreaticcancer. The method comprises administering an effective amount of acomposition comprising a compound of the invention to a subject; anddetecting the presence of a signal emitted from the imaging agent of thecompound of the invention in the subject, wherein detection of signalabove baseline indicates pancreatic cancer. In a specific embodiment,the present invention encompasses a method for detecting pancreaticcancer in a subject.

In still yet another aspect, the present invention encompasses a methodfor detecting, monitoring and/or treatment or prevention of early stagepancreatic ductal adenocarcinoma (PDAC) and precursor pancreaticintraepithelial neoplasia (PanIN). The method comprises administering aneffective amount of a composition comprising a compound of the inventionto a subject; and detecting the presence of a signal emitted from theimaging agent of the compound of the invention in the subject, whereindetection of signal above baseline indicates early stage pancreaticductal adenocarcinoma (PDAC) or pancreatic intraepithelial neoplasia(PanIN). In a specific embodiment, the present invention encompasses amethod for detecting early stage pancreatic ductal adenocarcinoma (PDAC)and precursor pancreatic intraepithelial neoplasia (PanIN).

In yet still another aspect, the present invention encompasses a methodfor differentiating pancreatic ductal adenocarcinoma (PDAC) andprecursor pancreatic intraepithelial neoplasia (PanIN) frompancreatitis. The method comprises administering an effective amount ofa composition comprising a compound of the invention to a subject; anddetecting the presence of a signal emitted from the imaging agent of thecompound of the invention in the subject, wherein detection of signalabove baseline indicates PDAC or PanIN and detection of a signal at orbelow baseline indicates pancreatitis.

In yet still another aspect, the present invention encompasses a methodfor differentiating pancreatic ductal adenocarcinoma (PDAC) and PanIN-3from PanIN-1/2 and ductal hyperplasia/metaplasia. The method comprisesadministering an effective amount of a composition comprising a compoundof the invention to a subject; and detecting the presence of a signalemitted from the imaging agent of the compound of the invention in thesubject, wherein detection of signal above baseline indicates PDAC orPanIN-3 and detection of a signal at or below baseline indicatesPanIN-1/2 or ductal hyperplasia/metaplasia.

In a different aspect, the present invention encompasses a method fordetecting and/or monitoring circulating tumor cells (CTCs). The methodcomprises administering an effective amount of a composition comprisinga compound of the invention to a subject; and detecting the presence ofa signal emitted from the imaging agent of the compound of the inventionin the subject, wherein detection of signal above baseline indicates thepresence of CTCs. In a specific embodiment, the present inventionencompasses a method for detecting CTCs in a subject.

By “treating, stabilizing, or preventing cancer” is meant causing areduction in the size of a tumor or in the number of cancer cells,slowing or preventing an increase in the size of a tumor or cancer cellproliferation, increasing the disease-free survival time between thedisappearance of a tumor or other cancer and its reappearance,preventing an initial or subsequent occurrence of a tumor or othercancer, or reducing an adverse symptom associated with a tumor or othercancer. In a desired embodiment, the percent of tumor or cancerous cellssurviving the treatment is at least 20, 40, 60, 80, or 100% lower thanthe initial number of tumor or cancerous cells, as measured using anystandard assay (e.g., caspase assays, TUNEL and DNA fragmentationassays, cell permeability assays, and Annexin V assays). Desirably, thedecrease in the number of tumor or cancerous cells induced byadministration of a compound of the invention is at least 2, 5, 10, 20,or 50-fold greater than the decrease in the number of non-tumor ornon-cancerous cells. Desirably, the methods of the present inventionresult in a decrease of 20, 40, 60, 80, or 100% in the size of a tumoror in the number of cancerous cells, as determined using standardmethods. Desirably, at least 20, 40, 60, 80, 90, or 95% of the treatedsubjects have a complete remission in which all evidence of the tumor orcancer disappears. Desirably, the tumor or cancer does not reappear orreappears after at least 5, 10, 15, or 20 years.

Suitable subjects include, but are not limited to, a human, a livestockanimal, a companion animal, a lab animal, and a zoological animal. Asubject may or may not be known to have a tumor. In one embodiment, thesubject may be a rodent, e.g. a mouse, a rat, a guinea pig, etc. Inanother embodiment, the subject may be a livestock animal. Non-limitingexamples of suitable livestock animals may include pigs, cows, horses,goats, sheep, llamas and alpacas. In yet another embodiment, the subjectmay be a companion animal. Non-limiting examples of companion animalsmay include pets such as dogs, cats, rabbits, and birds. In yet anotherembodiment, the subject may be a zoological animal. As used herein, a“zoological animal” refers to an animal that may be found in a zoo. Suchanimals may include non-human primates, large cats, wolves, and bears.In a preferred embodiment, the animal is a laboratory animal.Non-limiting examples of a laboratory animal may include rodents,canines, felines, and non-human primates. In another preferredembodiment, the subject is a human.

The methods of the invention may be used to detect, monitor, treat orprevent a tumor derived from a neoplasm or a cancer. The neoplasm may bemalignant or benign, the cancer may be primary or metastatic; theneoplasm or cancer may be early stage or late stage. Non-limitingexamples of neoplasms or cancers that may be treated include acutelymphoblastic leukemia, acute myeloid leukemia, adrenocorticalcarcinoma, AIDS-related cancers, AIDS-related lymphoma, anal cancer,appendix cancer, astrocytomas (childhood cerebellar or cerebral), basalcell carcinoma, bile duct cancer, bladder cancer, bone cancer, brainstemglioma, brain tumors (cerebellar astrocytoma, cerebralastrocytoma/malignant glioma, ependymoma, medulloblastoma,supratentorial primitive neuroectodermal tumors, visual pathway andhypothalamic gliomas, breast cancer, bronchial adenomas/carcinoids,Burkitt lymphoma, carcinoid tumors (childhood, gastrointestinal),carcinoma of unknown primary, central nervous system lymphoma (primary),cerebellar astrocytoma, cerebral astrocytoma/malignant glioma, cervicalcancer, childhood cancers, chronic lymphocytic leukemia, chronicmyelogenous leukemia, chronic myeloproliferative disorders, coloncancer, cutaneous T-cell lymphoma, desmoplastic small round cell tumor,endometrial cancer, ependymoma, esophageal cancer, Ewing's sarcoma inthe Ewing family of tumors, extracranial germ cell tumor (childhood),extragonadal germ cell tumor, extrahepatic bile duct cancer, eye cancers(intraocular melanoma, retinoblastoma), gallbladder cancer, gastric(stomach) cancer, gastrointestinal carcinoid tumor, gastrointestinalstromal tumor, germ cell tumors (childhood extracranial, extragonadal,ovarian), gestational trophoblastic tumor, gliomas (adult, childhoodbrain stem, childhood cerebral astrocytoma, childhood visual pathway andhypothalamic), gastric carcinoid, hairy cell leukemia, head and neckcancer, hepatocellular (liver) cancer, Hodgkin lymphoma, hypopharyngealcancer, hypothalamic and visual pathway glioma (childhood), intraocularmelanoma, islet cell carcinoma, Kaposi sarcoma, kidney cancer (renalcell cancer), laryngeal cancer, leukemias (acute lymphoblastic, acutemyeloid, chronic lymphocytic, chronic myelogenous, hairy cell), lip andoral cavity cancer, liver cancer (primary), lung cancers (non-smallcell, small cell), lymphomas (AIDS-related, Burkitt, cutaneous T-cell,Hodgkin, non-Hodgkin, primary central nervous system), macroglobulinemia(Waldenström), malignant fibrous histiocytoma of bone/osteosarcoma,medulloblastoma (childhood), melanoma, intraocular melanoma, Merkel cellcarcinoma, mesotheliomas (adult malignant, childhood), metastaticsquamous neck cancer with occult primary, mouth cancer, multipleendocrine neoplasia syndrome (childhood), multiple myeloma/plasma cellneoplasm, mycosis fungoides, myelodysplastic syndromes,myelodysplastic/myeloproliferative diseases, myelogenous leukemia(chronic), myeloid leukemias (adult acute, childhood acute), multiplemyeloma, myeloproliferative disorders (chronic), nasal cavity andparanasal sinus cancer, nasopharyngeal carcinoma, neuroblastoma,non-Hodgkin lymphoma, non-small cell lung cancer, oral cancer,oropharyngeal cancer, osteosarcoma/malignant fibrous histiocytoma ofbone, ovarian cancer, ovarian epithelial cancer (surfaceepithelial-stromal tumor), ovarian germ cell tumor, ovarian lowmalignant potential tumor, pancreatic cancer, pancreatic cancer (isletcell), paranasal sinus and nasal cavity cancer, parathyroid cancer,penile cancer, pharyngeal cancer, pheochromocytoma, pineal astrocytoma,pineal germinoma, pineoblastoma and supratentorial primitiveneuroectodermal tumors (childhood), pituitary adenoma, plasma cellneoplasia, pleuropulmonary blastoma, primary central nervous systemlymphoma, prostate cancer, rectal cancer, renal cell carcinoma (kidneycancer), renal pelvis and ureter transitional cell cancer,retinoblastoma, rhabdomyosarcoma (childhood), salivary gland cancer,sarcoma (Ewing family of tumors, Kaposi, soft tissue, uterine), Sézarysyndrome, skin cancers (nonmelanoma, melanoma), skin carcinoma (Merkelcell), small cell lung cancer, small intestine cancer, soft tissuesarcoma, squamous cell carcinoma, squamous neck cancer with occultprimary (metastatic), stomach cancer, supratentorial primitiveneuroectodermal tumor (childhood), T-Cell lymphoma (cutaneous),testicular cancer, throat cancer, thymoma (childhood), thymoma andthymic carcinoma, thyroid cancer, thyroid cancer (childhood),transitional cell cancer of the renal pelvis and ureter, trophoblastictumor (gestational), enknown primary site (adult, childhood), ureter andrenal pelvis transitional cell cancer, urethral cancer, uterine cancer(endometrial), uterine sarcoma, vaginal cancer, visual pathway andhypothalamic glioma (childhood), vulvar cancer, Waldenströmmacroglobulinemia, and Wilms tumor (childhood). In a specificembodiment, the neoplasm or cancer is pancreatic cancer.

The invention comprises, in part, imaging a subject. Non-limitingexamples of modalities of imaging may include magnetic resonance imaging(MRI), ultrasound (US), computed tomography (CT), Positron EmissionTomography (PET), Single Photon Emission Computed Tomography (SPECT),and optical imaging (OI, bioluminescence and fluorescence). Radioactivemolecular probes are traditionally imaged with PET, SPECT or gamma (γ)cameras, by taking advantage of the capability of these imagingmodalities to detect the high energetic γ rays. In contrast, OIgenerally detects low energy lights (visible or near-infrared lights)emitted from bioluminescence or fluorescence probes.

As used herein, “baseline” may be the background signal. Alternatively,baseline may be no signal. In a specific embodiment, baseline is thesignal detected in uninvolved tissue. A skilled artisan would be able todetermine the baseline of a signal. By above is meant that the signal isgreater than the baseline signal. For example, the signal may be atleast 2% greater than baseline. For example, the signal may be at least2%, at least 5%, at least 10%, at least 20%, at least 30%, at least 40%,at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, orat least 100% greater than baseline. In a specific embodiment, thesignal is >20% above baseline. In other embodiments, the signal may beincreased at least 2-fold over baseline. For example, the signal may beincreased at least 2-fold, at least 5-fold, at least 10-fold, at least15-fold, at least 20-fold, at least 25-fold, at least 30-fold, at least35-fold, at least 40-fold, at least 45-fold, or at least 50-fold overbaseline.

The term “signal” as used herein, refers to a signal derived from animaging agent that can be detected and quantitated with regards to itsfrequency and/or amplitude. The signal may be an optical signal. Thesignal can be generated from one or more imaging agents of the presentdisclosure. In an embodiment, the signal may need to be the sum of eachof the individual signals. In an embodiment, the signal can be generatedfrom a summation, an integration, or other mathematical process,formula, or algorithm, where the signal is from one or more imagingagent. In an embodiment, the summation, the integration, or othermathematical process, formula, or algorithm can be used to generate thesignal so that the signal can be distinguished from background noise andthe like. It should be noted that signals other than the signal ofinterest can be processed and/or obtained in a similar manner as that ofthe signal of interest.

Using a method of the invention, microscopic lesions of cancer may bedetected in a subject. Such lesions are generally not visible withcurrent imaging techniques. Further the compounds of the disclosure maybe used to guide needle biopsy, assess surgical margins, and detectoccult metastatic disease in real time.

In certain aspects, a pharmacologically effective amount of a compoundof the invention may be administered to a subject. Administration isperformed using standard effective techniques, including peripherally(i.e. not by administration into the central nervous system) or locallyto the central nervous system. Peripheral administration includes but isnot limited to intravenous, intraperitoneal, subcutaneous, pulmonary,transdermal, intramuscular, intranasal, buccal, sublingual, orsuppository administration. Local administration, including directlyinto the central nervous system (CNS) includes but is not limited to viaa lumbar, intraventricular or intraparenchymal catheter or using asurgically implanted controlled release formulation.

Pharmaceutical compositions for effective administration aredeliberately designed to be appropriate for the selected mode ofadministration, and pharmaceutically acceptable excipients such ascompatible dispersing agents, buffers, surfactants, preservatives,solubilizing agents, isotonicity agents, stabilizing agents and the likeare used as appropriate. Remington's Pharmaceutical Sciences, MackPublishing Co., Easton Pa., 16Ed ISBN: 0-912734-04-3, latest edition,incorporated herein by reference in its entirety, provides a compendiumof formulation techniques as are generally known to practitioners. Itmay be particularly useful to alter the solubility characteristics ofthe compounds useful in this discovery, making them more lipophilic, forexample, by encapsulating them in liposomes or by blocking polar groups.

Effective peripheral systemic delivery by intravenous or intraperitonealor subcutaneous injection is a preferred method of administration to aliving patient. Suitable vehicles for such injections arestraightforward. In addition, however, administration may also beeffected through the mucosal membranes by means of nasal aerosols orsuppositories. Suitable formulations for such modes of administrationare well known and typically include surfactants that facilitatecross-membrane transfer. Such surfactants are often derived fromsteroids or are cationic lipids, such asN-[1-(2,3-dioleoyl)propyl]-N,N,N-trimethyl ammonium chloride (DOTMA) orvarious compounds such as cholesterol hemisuccinate, phosphatidylglycerols and the like.

For therapeutic applications, a therapeutically effective amount of acomposition of the invention is administered to a subject. A“therapeutically effective amount” is an amount of the therapeuticcomposition sufficient to produce a measurable biological tumor response(e.g., an immunostimulatory, an anti-angiogenic response, a cytotoxicresponse, or tumor regression). Actual dosage levels of activeingredients in a therapeutic composition of the invention can be variedso as to administer an amount of the active compound(s) that iseffective to achieve the desired therapeutic response for a particularsubject. The selected dosage level will depend upon a variety of factorsincluding the activity of the therapeutic composition, formulation, theroute of administration, combination with other drugs or treatments,tumor size and longevity, and the physical condition and prior medicalhistory of the subject being treated. In some embodiments, a minimaldose is administered, and dose is escalated in the absence ofdose-limiting toxicity. Determination and adjustment of atherapeutically effective dose, as well as evaluation of when and how tomake such adjustments, are known to those of ordinary skill in the artof medicine.

For diagnostic applications, a detectable amount of a composition of theinvention is administered to a subject. A “detectable amount”, as usedherein to refer to a diagnostic composition, refers to a dose of such acomposition that the presence of the composition can be determined invivo or in vitro. A detectable amount will vary according to a varietyof factors, including but not limited to chemical features of thepeptide being labeled, the imaging agent, labeling methods, the methodof imaging and parameters related thereto, metabolism of the labeleddrug in the subject, the stability of the label (e.g. the half-life of aradionuclide label), the time elapsed following administration of thecompound prior to imaging, the route of drug administration, thephysical condition and prior medical history of the subject, and thesize and longevity of the tumor or suspected tumor. Thus, a detectableamount can vary and can be tailored to a particular application. Afterstudy of the present disclosure, and in particular the Examples, it iswithin the skill of one in the art to determine such a detectableamount. A detectable amount may be visible from about 1 to about 120hours or more. For example, a detectable amount may be visible fromabout 1 to about 110 hours, or from about 1 to about 100 hours.Accordingly, a detectable amount may be visible at about 1, about 2,about 3, about 4, about 5, about 6, about 7, about 8, about 9, about 10,about 11, about 12, about 16, about 24, about 36, about 48, about 60,about 72, about 84, about 96, about 108, or about 120 hours.

The frequency of dosing may be daily or once, twice, three times or moreper week or per month, as needed as to effectively treat the symptoms.The timing of administration of the treatment relative to the diseaseitself and duration of treatment will be determined by the circumstancessurrounding the case. Treatment could begin immediately, such as at thesite of the injury as administered by emergency medical personnel.Treatment could begin in a hospital or clinic itself, or at a later timeafter discharge from the hospital or after being seen in an outpatientclinic. Duration of treatment could range from a single doseadministered on a one-time basis to a life-long course of therapeutictreatments.

Although the foregoing methods appear the most convenient and mostappropriate and effective for administration of peptide constructs, bysuitable adaptation, other effective techniques for administration, suchas intraventricular administration, transdermal administration and oraladministration may be employed provided proper formulation is utilizedherein.

In addition, it may be desirable to employ controlled releaseformulations using biodegradable films and matrices, or osmoticmini-pumps, or delivery systems based on dextran beads, alginate, orcollagen.

Typical dosage levels can be determined and optimized using standardclinical techniques and will be dependent on the mode of administration.

In certain aspects, the methods of the invention may further compriseadministering therapeutic agents not conjugated to a compound of theinvention for neoplasms and cancer. Suitable therapeutic agents forneoplasms and cancers are known in the art, and will depend upon thetype and stage of cancer. Summaries of cancer drugs, includinginformation regarding approved indications, may be found via theNational Cancer Institute at the National Institutes of Health(www.cancer.gov/cancertopics/druginfo/alphalist) and the FDA ApprovedDrug Product database (accessdata.fda.gov/scripts/cder/drugsatfda/).

Definitions

The term “detect” as used herein refers to diagnostic procedures andmethods to image the compounds of the invention. These proceduresinclude, but are not limited to, optical tomography, fluorescenceendoscopy, imaging detection or measurement of or by fluorescence andimaging absorption, light scattering, acoustic, sonographic, magneticresonance, or radiation means.

The term “hydrocarbyl” as used herein describe organic compounds orradicals consisting exclusively of the elements carbon and hydrogen.These moieties include alkyl, alkenyl, alkynyl, and aryl moieties. Thesemoieties also include alkyl, alkenyl, alkynyl, and aryl moietiessubstituted with other aliphatic or cyclic hydrocarbon groups, such asalkaryl, alkenaryl and alkynaryl. Unless otherwise indicated, thesemoieties preferably comprise 1 to 20 carbon atoms.

The term “localized therapy” is a procedure for administering a compoundof the invention directly into pathological tissue. Treatment inlocalized therapy may be accomplished by photo-, chemical-, orbiological activation of the compound of the invention. Photoactivationmay be conducted with light within a specific wavelength range. Chemicalactivation may be induced cytotoxicity. Biological activation may beinitiated by physiological and molecular processes, including enzymaticactivation of the compound.

The term “monitoring” as used herein refers to the continued orintermittent detection and may be combined with treatment for purposesincluding, but not limited to, ascertaining the progress or mechanism ofpathology and efficacy of a particular treatment regime.

The term “substituted hydrocarbyl” moieties described herein arehydrocarbyl moieties which are substituted with at least one atom otherthan carbon, including moieties in which a carbon chain atom issubstituted with a hetero atom such as nitrogen, oxygen, silicon,phosphorous, boron, sulfur, or a halogen atom. These substituentsinclude halogen, carbocycle, aryl, heterocyclo, alkoxy, alkenoxy,alkynoxy, aryloxy, hydroxy, protected hydroxy, keto, acyl, acyloxy,nitro, amino, amido, nitro, cyano, thiol, ketals, acetals, esters andethers.

The term “treat” or “treatment” includes partial or total inhibition ofthe progression of a particular disorder. For example when the disorderis cancer, treatment include partial or total inhibition of neoplasiagrowth, spreading or metastasis, as well as partial or total destructionof the neoplasia cells. Treatment also includes prevention of aneoplasia or related disorder. By way of further example when thedisorder is inflammation, the term “treat” also includes partial ortotal inhibition of inflammation or an inflammation related disorder.Treatment also includes prevention of an inflammation or inflammationrelated disorder.

As various changes could be made in the above compounds, products andmethods without departing from the scope of the invention, it isintended that all matter contained in the above description and in theexamples given below, shall be interpreted as illustrative and not in alimiting sense.

EXAMPLES

The following examples are included to demonstrate preferred embodimentsof the invention. It should be appreciated by those of skill in the artthat the techniques disclosed in the examples that follow representtechniques discovered by the inventors to function well in the practiceof the invention, and thus can be considered to constitute preferredmodes for its practice. However, those of skill in the art should, inlight of the present disclosure, appreciate that many changes can bemade in the specific embodiments which are disclosed and still obtain alike or similar result without departing from the spirit and scope ofthe invention.

Example 1. Improved RD Targeting Compounds

Compare the Performance of the Different Sequences:

A variety of probes which have similar sequence compared to LS301 weredesigned and prepared (Table 1). The probes have different peptidesequences, D-, L-amino acid variations or different groups onC-terminus. The sequences of the probes were tested by LC-MS and thespectroscopy properties were recorded. The performances of the tumortargeting abilities were also tested in vivo. We discovered LS838(FIG. 1) has better brightness after accumulation inside the cancertumors and the targeting performance is similar to LS301. It wasunexpected that LS838 would be brighter relative to LS301 and it isunknown to us why it does. However, the enhanced brightness allows theuse of smaller amounts of material to achieve the same uptake kineticsand accumulation as LS301. FIG. 5 depicts the accumulation of LS838 invivo and FIG. 6 graphically quantifies the intensity of LS838 in variousorgans. LS838 precisely accumulates in the tumor at 24 hours. LS838labeled can be labeled with radionuclides such as radio-iodine, bromine,or fluorine for combined optical and nuclear imaging. The labeling doesnot alter the excellent tumor localizing properties. Notably, in vivoadministration of LS747 and LS758, both of which have a Tyr adjacent tothe cypate, led to rapid loss of retention in tumors. These resultssuggest that the position of the Tyr residue is important.

TABLE 1 Compounds prepared for performance comparison with LS301 peptideNo. Sequence SEQ ID NO LS301Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH  1 LS651Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys)-Lys-OH  2 LS652Cypate-Cyclo(Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH  3 LS653Cypate-Cyclo(Cys-Arg-Gly-Asp-Ser-Pro-Cys)-Lys-OH  4 LS654Cypate-Cyclo(_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys)-Lys-OH  5 LS655Cypate-Cyclo(_(D)Cys-Arg-Gly-Asp-Ser-Pro-_(D)Cys)-Lys-OH  6 LS747Cypate-Tyr-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH  7 LS748Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-Tyr-OH  8 LS758Tyr-Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-NH₂  1 LS837Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-NH₂  1 LS838Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr-OH  9 LS839Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr-Lys-OH 10 LS839-2Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-Tyr-NH₂  8

Compare the Performance of the LS301 Derivative with Fluorophores withDifferent Hydrophobicity:

LS301 derivatives with fluorophores with different hydrophobicity wereprepared to test if the hydrophobicity of the dye on the same peptidesequence will affect the targeting performance. Four of the NIR dyeswith different hydrophobicity (FIG. 2) beside cypate were attached tothe same GRD peptide (Table 2). These probes were tested in vivo tocompare with LS301.

TABLE 2Compounds prepared with fluorophores with different hydrophobicity No.Sequence SEQ ID NO LS636LS288-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1 LS840LS798-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1 LS841LS276-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1 LS844LS843-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1

Multicolor LS301 Derivatives for Non-Invasive Molecular Imaging:

LS301 derivatives were prepared with different cyanine dyes (cypate 3and cypate 2, FIG. 3 and FIG. 4) which have emission wavelength (Table3). These probes were tested in vivo and will allow the use of differentwavelengths for the optical imaging.

TABLE 3Compounds prepared with cyanine dyes with different emission wavelengthNo. Sequence SEQ ID NO LS789Cypate 3-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1 LS858Cypate 2-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys-OH 1

Multimodality LS301 Derivatives for Non-Invasive Molecular Imaging:

A variety of the multimodality LS301 derivatives readily available forradio-isotope labeling were designed and prepared (Table 4). Theseprobes can be used for nuclear-imaging with the superior performance oftargeted optical imaging, providing versatile application in differenttype of cancer diseases. The cold labeled probes were prepared andtested in vivo to compare with LS301. FIG. 13 provides an example ofderivatization of the cypate for incorporation of drugs, biologicallyactive molecules and/or radio-halogens.

TABLE 4 Compounds prepared for multimodal imaging. SEQ ID No. CompoundStructures NO LS838 Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr-OH9 LS848 alkyne- alkyne-Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)- 1LS301 Lys-OH LS859 Azido-N3-Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Lys- 1 LS301 OH LS861DTPA- DTPA-Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)- 1 LS301 Lys-OHLS862 DTPA- DTPA-Cypate-Cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys)- 9 LS838Tyr-OH

Example 2. Design and Identification of LS838 as a Pancreatic DuctalAdenocarcinoma (PDAC) Imaging Agent

The current strategy to develop molecular probes with high bindingaffinity to a protein receptor overexpressed on tumor cells has allowedimaging of bulk tumor masses in vivo. Identifying gross tumors isstraightforward in most cases. Unlike the bulk tumor, however, smalltumors are surrounded by non-tumor tissue which also expresses thetarget receptor. Although the target protein is usually expressed atlower levels, the large surface area of the surrounding tissue increasesthe net background fluorescence, significantly decreasing the contrastbetween pathologic and uninvolved tissues. This concern was realizedwhen previous attempts to use a dye-labeled RGD peptide or octreotate totarget αvβ3 integrin or somatostatin receptors, respectively, reportedlyoverexpressed in PDAC, were not successful in identifying early stagePDAC. It was concluded that what is needed is a secondary trappingmechanism that can longitudinally retain a molecular probe in malignantcells while it clears from non-target tissue.

A new fluorescent molecular probe, LS838 (FIG. 7A) selectively targetsearly and late stages of PDAC. LS838 is a small molecule (<1.6 kDa)consisting of a NIR fluorescent dye (cypate) and an octapeptide that iscyclized through a disulfide bond. Cypate has a biological clearanceprofile and spectral properties (absorption, emission, quantum yield)similar to the FDA-approved indocyanine green (ICG; FIG. 7A), which isnot tumor selective and does not react with biomolecules for targeteddelivery to tumors. The spectral properties of LS838 are suitable forNIR fluorescence imaging studies (excitation/emission 785/810 nm inserum and 20% aq. DMSO solution; molar absorptivity, ε, 240,000 M⁻¹;cm⁻¹; and fluorescence quantum yield, iv, 10%). Cypate binds reversiblyto the hydrophobic pocket of albumin, a source of nitrogen and energyfor tumors. Unlike covalently dye-labeled albumin, cypate is released intumors under mild acidic conditions as it traffics through the endosomalpathway. The released cypate is only transiently retained in tumorsbefore efflux, limiting the tumor-to-background contrast.

To overcome this problem, the use of peptides as a tumor-trappingmechanism was explored. The highly reducing environment of tumor cellsis known to reduce disulfide bonds to thiols, which can trans-thiolatewith cysteine-containing intracellular proteins to trap the molecularprobe. Therefore, a variety of disulfide-containing peptides wereconjugated to cypate and the compounds were screened in mice withadvanced stage PDAC. Results showed that LS838 was selectively retainedin tumors for over 48 h, longer than the other peptide conjugates.Structure-tumor retention analysis revealed that the unnaturalD-Cysteine linked to cypate confers high stability on the molecularprobe because of its resistance to degradation by proteases. Replacementof the D-Cysteine with the natural L-Cysteine residue abrogates thisretention.

NIR fluorescence microscopy of LS838 in diverse tumor cells showedpunctate intracellular fluorescence typical of receptor-mediatedendocytosis (FIG. 8) and that the fluorescence uptake was barely visiblein non-tumor cells (not shown). At early time points, LS838 is largelyin the lysosomes, but it translocates to the cytosol in a time-dependentmanner. Western blot, proteomic analysis, and blocking studies in cellswith diverse inhibitors of albumin endocytosis point to albumin-mediatedendocytosis (data not shown). This mechanism of uptake was furthersupported in vitro and in vivo by co-incubation of Alexa 680 labeledbovine serum albumin (BSA) with LS838, which showed colocalization ofthe two fluorophores in cancer cells at early time points, followed bydivergence of the signals, indicating retention of LS838 and efflux ofthe Alexa 680.

Example 3. LS838 Selectively Detects PDAC and Precursor PancreaticIntraepithelial Neoplasia (PanIN) Cells with High Accuracy, andDistinguishes these Lesions from Acute and Chronic Pancreatitis

LS838, genetically engineered KPC mice(p48-CRE/LSL-Kras^(G12D)/p53^(Flox/+); activate KRAS and inactivatep53), and noninvasive fluorescence molecular tomography (FMT) were usedto delineate pancreatic lesions. A high-speed FMT system was developedfor quantitative imaging of molecular processes in vivo. Usingquantitative FMT, results show that intravenous (i.v.) administration ofLS838 allowed the detection of PDAC/PanIN lesions, which can bedifferentiated from acute and chronic pancreatitis (FIG. 9A-E).Reconstructed images 10 mm from the dorsal sides are shown for thedifferent mice models. NIR fluorescence in the pancreatic region wasdrastically lower in both pancreatitis and Matrigel control modelscompared to that in PDAC and early neoplasia. The pancreas fromdifferent animal models was excised and imaged ex vivo. For theorthotopically implanted PDAC, fluorescence in the pancreas head wasseen within a week of implantation, and the intensity increased by afactor of two within 2 weeks post-implant (FIG. 9A-B). Unlike the focalorthotopic tumor in the pancreas, the spontaneous model (PanIN/KPC)showed diffuse fluorescence in the pancreas (FIG. 9C). This is notsurprising because this model readily transforms the majority of thepancreas into fully malignant tissue by the time the animals are 3-4months of age. In contrast, LS838 fluorescence was barely detectable inthe chronic and acute pancreatitis models, as well as in the controlorthotopic Matrigel implant (FIG. 9D-E).

Histologic validation of the presence of pancreatic tumor cells in theLS838 fluorescent regions was performed by comparing the NIRfluorescence in tissue sections with hematoxylin and eosin (H&E) stainedtissues (FIG. 10). The results confirmed the accurate detection of PDACand precursor PDAC cells by LS838. Importantly, ex vivo tissue analysisof the chronic pancreatitis model showed significant fluorescence in afew areas of the pancreas which appears to correlate with PanIN-3lesions that are known to progress to PDAC (FIG. 10D).

To determine the cell type(s) that take up LS838 in vivo, mice bearingestablished PDAC tumors stably transfected with a KP mCher⁺ fluorescencereporter were treated with LS838. Tumor tissue was harvested anddissociated by collagenase digestion to obtain single-cell suspensionsfor analysis by flow cytometry. Using mCherry to identify PDAC tumorcells, it was found that uptake by these malignant cells was 100 to1,000 times higher than in other cell types (FIG. 11A). Modest uptakewas also seen in tumor infiltrating macrophages, but these macrophageswere also labeled with mCherry derived from the tumor cells themselves,suggesting this fluorescence was a product of phagocytosis of PDAC cells(FIG. 11B).

Example 4. NIR Fluorescence Laparoscopy Using LS838 Accurately DetectsPDAC and Premalignant Neoplasia and Delineates these Lesions fromPancreatitis

For laparoscopy, the Karl Storz rigid, straightforward telescope wasmodified so that it was capable of imaging in both visible (color; RGB)and NIR fluorescence modes. In the RGB mode, an endoscopic cold lightfountain (Xenon Nova 175) with adjustable light intensity was used asthe light source. The light cable was coupled to the illuminationchannel on a 0-degree Hopkins straightforward telescope. Images werecaptured by an NIR-sensitive CCD camera (Fluorvivo) with an RGB Bayerfilter. A telescope coupler with a focus ring focused the CCD camera onthe image formation plane at the back of the telescope. In thefluorescence mode, the cold light fountain source was replaced by a780-nm excitation laser source with an incident light of 5 mW reachingthe tissue. An 800-nm long-pass emission filter was placed behind thetelescope in a slit of a custom-made adapter designed to couple themacro lens to the telescope. Images were captured using the FluorvivoCCD camera with a quantum efficiency of 30% at 800 nm. Using this setup,the four murine models were investigated to provide validity to thisapproach. A midline incision was made to expose the peritoneal cavity ofthe mouse and the cavity was imaged at 90 degrees with a fixed distanceof 4 cm. As shown in FIG. 12, the pancreas can be readily visualized bythe conventional color image, but the LS838 NIR fluorescence selectivelyhighlighted tumor tissues. Fluorescence in uninvolved pancreas and acutepancreatitis was below the detection limit of our device. Particularlyexciting is the differential fluorescence in the involved and uninvolvedpancreas, suggesting the ability to use this method to guide needlebiopsy, assess surgical margins, and detect occult metastatic disease inreal time. The detection sensitivity of the endoscope is low relative toa commercial system recently developed by Karl Storz, the Image 1H3-ZNIR fluorescence endoscope.

The encouraging results support the development of LS838 for detectionof pancreatic lesions. In addition to delivering optical imaging agentsand potentially drugs to PDAC lesions, the presence of tyrosine in LS838structure allows for future radiolabeling of the molecule fornoninvasive nuclear imaging applications.

Example 5. Synthesize and Characterize LS838 Analogues to Understand theMechanism of LS838 Uptake and Retention in PDAC Relative to UninvolvedPancreatic Cells

The unprecedented retention of LS838 in pancreatic cells undergoingoncogenic transformation and PDAC cells requires further understandingof the retention mechanism. This is more so because the compound is nottrapped in cells undergoing inflammation—as in acute or wound healingmodels. When some cells lit up in the chronic pancreatitis model, thesecells were in the late stage of PanIN, thereby identifying the onset ofPDAC. These studies were carried out in different animal models ofpancreatic cancer with similar outcomes. The objectives of this studyare to determine the trapping mechanism of LS838 in PDAC/PanIN tissues,improve the biodistribution profile of the compound so that fluorescencein adjacent organs and uninvolved pancreas will be minimal within anhour post injection of the agent, and formulate the compound for ease ofadministration and reduced uptake in non-target tissues.

Determine the Effects of Dyes and Peptides on the Uptake and Retentionof LS838 in PDAC/PanIN.

Data strongly suggests albumin-mediated facilitated transport of LS838into PDAC/PanIN-2/3 cells.

Dye Effect:

The hypothesis is that the binding of cypate to albumin facilitates theinternalization of LS838 in PDAC/PanIN lesions. In a previous study, thebinding of some carbocyanine dyes to albumin was compared. It was foundthat ICG and cypate possessed the strongest binding constant (K) toalbumin, with values of 554,000 M⁻¹ and 556,000 M⁻¹ respectively,followed by LS276 (135,000 M⁻¹); LS288 bound the weakest (12,100 M⁻¹).The structures of LS288 and LS276 are shown in FIG. 7B-C. It was alsoshown that conjugation of peptides to the dyes decreases the K by afactor of ˜10. Using the same method, we determined the K value of LS838to be 86,000 M⁻¹.

By conjugating dyes with disparate albumin-binding constants to the samepeptide sequence, this will validate the role of the dyes in the uptake,and possible retention, of the molecular probes. This will allow for thedesign of alternative compounds to LS838, if needed. Thefunctionalizable dyes (Cypate, LS288, and LS276) will be conjugated tothe LS838 peptide (denoted as GRD peptide; note that this is not theconventional RGD peptide).

For cell studies, each of the LS288 and LS276 conjugates of the RGDpeptides (1 μM) will be incubated with the established PDAC cells. Flowcytometry will be used to quantitatively determine the rate ofinternalization by calculating the slope of a plot of fluorescence vs.time in 1000 cells (0.5, 1, 2, 4, and 8 h post incubation).Intracellular retention will be determined by washing the cells after 24h incubation (when cytosolic fluorescence can be seen in cells treatedwith LS838). The cells will be incubated in fresh medium and the effluxrate (rate of fluorescence decrease with time at 0.5, 1, 2, 4, and 8 hpost incubation after washing) will be determined by NIR flow cytometryusing 1000 cells. The results will be compared with that of LS838 toestablish the role of dyes in PDAC uptake and retention. By using a rateconstant to report uptake and retention, bias in data analysis causeddifferences in the brightness (quantum yield×molar absorptivity) of eachdye will be avoided. It is expected that the rate of internalizationwill correlate with the dye-albumin binding affinity, but that theretention rate will be similar if this parameter is mediated by thepeptide (the same peptide is used) or aggresome (cell type effect; seebelow). Statistically significant differences in retention rates willindicate that the dyes also play a role in this parameter. Thisinformation will be used to optimize the molecular probe by combiningfeatures that favor fast internalization with those that promote highintracellular retention. If these parameters conflict, high retentionrate over internalization rate will be chosen to achieve highfluorescence in tumor cells compared to non-tumor cells.

Peptide Effect:

Data shows that cypate dye alone internalizes in tumor cells, but thenrapidly effluxes when the cells are transferred to a new culture medium.A similar trend is observed in vivo, where preferential uptake in PDACrelative to uninvolved pancreas is not observed. It was also found thatreplacement of D-cysteine with L-cysteine abrogated retention of LS838in PDAC. Similarly, use of other cypate-labeled disulfide cyclicoctapeptides, such as octreotate, did not achieve statisticallysignificant contrast between PDAC and the surrounding pancreas. Theseresults suggest that the peptide plays an important role in theselective retention of LS838 in PDAC tissue. Permutation of thearginine-aspartic acid sequence results in a loss of PDAC-selectiveuptake. It has been shown that cypate binds to the hydrophobic pocketsof albumin, irrespective of the source (human, murine, or bovine). Thereduction in binding constant upon conjugation with peptides suggeststhat the peptides perturb the albumin-dye interaction. Thus, the primarygoal of this study is to determine the role of the peptide in tumor cellinternalization or retention. Based on preliminary data, this questioncan be addressed by preparing the following cypate-labeled peptides(underlined amino acids are changes made to LS838):

(SEQ ID NO: 11) cyclo(_(D)Cys-Gly-Arg-Asp-Ser-Pro- _(D)Cys)-Tyr-OH;(SEQ ID NO: 12) cyclo(Cys-Gly-Arg-Asp-Ser-Pro-Cys)-Tyr-OH;(SEQ ID NO: 13) cyclo(Cys-Aro-Gly-Asp-Ser-Pro-Cys)-Tyr-OH;(SEQ ID NO: 14) cyclo(_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys)-Tyr-OH; and(SEQ ID NO: 15) cyclo(_(D)Cys-Arg-Gly-Asp-Ser-Pro- _(D)Cys)-Tyr-OH.

The peptides will be prepared and labeled with cypate at the N-terminus.The albumin binding constants will be determined as described above toassess the perturbation of the dye-albumin interaction, which couldaffect cell uptake. Using the internalization and retention ratesdescribed above, whether loss of contrast is due to poor uptake or poorretention in tumors will be determined. The data will allow thedetermination if loss of PDAC selectivity is caused by a poorinternalization rate due to perturbation of the dye-albumin binding. Inthat case, spacers will be incorporated, such as various lengths ofpolyethyleneglycols, between the dye and the peptide to minimize thisperturbation. If the loss of uptake is caused by a high efflux rate, theintracellular target of LS838 will be determined, as described below.

Determine the Mechanism of Selective Trapping of LS838 in PancreaticLesions.

Data indicate that LS838 rapidly internalizes in the pancreas within 1 hpost injection, but then remains primarily in the tumor cells (up to 100h) relative to non-tumor cells. Cellular studies suggest that LS838undergoes time-dependent translocation from the lysosome to the cytosolin cancer cells, but remains in the lysosomes in non-tumor cells beforeefflux from the cells. This trafficking profile was not observed withthe control probes nor with the cypate dye alone, which showed transientretention in tumor cells before efflux in a similar manner as non-tumorcells. Proteomics studies show the association of LS838 with a proteindetermined to possess a significant albumin peptide sequence. Westernblot analysis indicated the association of LS838 fluorescence withα-actinin-4 protein and a fatty acid receptor protein. Therefore, tounderstand why LS838 is able to be selectively retained by pancreatictumors, two hypotheses will be tested.

Hypothesis 1: A Dysfunction in the Clearance of LS838 from Cancer CellsWill Decrease the Efflux Rate, Thereby Increasing the Selective andLongitudinal Retention of the Imaging Agent in Cancer Cells.

Data show that a significant amount of LS838 is retained in thelysosomes for over 24 h in tumor cells, but lies in a perinuclearinclusion in normal cells. Aggresomes are microtubule-catalyzedaggregates of lysosomes that are used to degrade particularly stable andaggregated proteins. It is postulated that LS838 forms stable aggregateswith albumin which may require the formation of aggresomes for theirremoval. It will be evaluated if tumors have a lower ability to formaggresomes because of microtubule dysfunction, leading to prolongedretention in tumor cells compared to normal cells. If LS838 inducesaggresome formation in tumor cells, but not fibroblasts will first bedetermined. Using the ProteoStat Aggresome detection kit, an assay foraggresome formation will be performed using literature methods. It willalso be determined if aggresomes form in vivo using a literature method.LS838 will be injected into mice and they will be euthanized 24 h postinjection. Aggresome formation will be determined by staining muscle,skin, and tumors for anti-ubiquitin protein. Aggresome formation will beconfirmed by TEM visualization of perinuclear inclusions. Controlstudies with LS838N and cypate will be conducted. The hypothesis will bepositively tested by demonstrating that the rate of aggresome formationin PDAC cells is slower than in non-tumor pancreatic cells, with ap≤0.05.

Hypothesis 2: Longitudinal Retention of LS838 in Cancer Cells isMediated by Trans-Thiolation with Intracellular Biomolecules Via theStable (Unnatural) D-Cysteine Amino Acid Linked to Cypate.

Data show that LS838 can be internalized in tumors, but rapidly clearsbefore attaining significant tumor-to-background contrast if any one ofthe D-cysteine, lysine, or aspartic acid residues is replaced withdifferent amino acids. In one set of proteomic data, which was confirmedby Western blot, α-actinin-4 protein (˜104 kDa) and fatty acid receptorproteins (˜37 kDa; 15 kDa) were identified as potential intracellulartargets for LS838. It is expected that under the high reducingintracellular environment of cancer cells, the reduced thiol groups ofα-actinin-4 can cross-link with the thiol from the D-cysteine of LS838peptide. It is likely that the hydrophobic cypate dye interacts with thefatty acid receptor, providing sufficient resident time in cells fortrans-thiolation to occur.

A proteomic approach will be utilized to identify the intracellularbiomolecules that bind strongly with LS838 in cancer cells. The cellswill be trypsinized and lysed, and then the lysed protein will befractionated and analyzed for NIR fluorescence. Compared to non-treatedcell protein distributions along the anionic exchange column, boundproteins will be slightly shifted in their anionic charge in the treatedcells. The combination of anionic shift and overlap in NIR fluorescencewill help identify candidate proteins for binding affinity. Proteinsshifted in anionic charge by LS838, but not shifted by cypate, will beused to identify candidates for proteins involved in retention. Theidentified proteins that match the above criteria will then be analyzedfor binding affinity using a competitive binding assay. To normalize thedata, the binding affinity will be expressed as apparent bindingconstants. Confirmation of a protein's retention effect will bedetermined by pre-incubating tumor cells with competitive inhibitors ofthe protein. It is expected that there will be a significant loss ofLS838 retention in tumor cells, which will be expressed as percentinhibition. Additionally, siRNA may be used to knockout/down the targetprotein to establish functional validation of the retention mechanism.All experiments will be conducted with cypate and dye-labeled peptidederivatives.

Determination of the Cytotoxicity of LS838:

To assess the cytotoxicity of LS838, commercially available normal(non-tumor) human primary pancreatic cells (T0199 from ABM), andnon-tumor cell lines from the two major excretion organs, the kidneys(HK-2) and liver (Fa2N-4) will be used. Primary pancreaticadenocarcinoma (BXPC3) or other cancer cell lines will also be used toassess potential toxicity in tumors. The cytotoxicity tests will beperformed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay. Based on a previous study, it is expected that themolecular probes will have a lethal dose (LD50)>100 μM in cells, whichis orders of magnitude above what is expected to be used for in vivoimaging. The NIR confocal microscope (FV1000, Olympus) will be used toassess the intracellular distribution of the probes. All the methods forthese assays are standard.

LS838 currently clears through the liver. While this is not a problem inthe proposed laparoscopy, the excretion route to the kidneys can bealtered by conjugating positively charged moieties (—⁺NMe₃) or nonionicgroups (e.g. PEG) to the free carboxylic acid group of cypate. It wasfound that conjugation of small molecules (<500 Da) does not affectLS838 binding to tumors. In the unlikely event that the cyanine dyes arephoto-unstable, they will be replaced with NIR pyrrolopyrrole cyaninedyes (PPCy), which are highly photostable and have exceptionally highfluorescence quantum yields (up to 80%).

Example 6. Determine the Role of Kras-Induced Oncogenic Transformationon the Selective Uptake and Retention of LS838 by PDAC/PanIN-2/3

The detection and differentiation of advanced lesions (PanIN-3 and PDAC)from more indolent disease (PanIN-1/2) and ductal hyperplasia/metaplasiawould inform more aggressive treatment decisions. It will also bedetermined if activated Kras-mediated oncogenic transformation ofnon-malignant pancreatic cells to PDAC drives specific uptake andretention of LS838 in malignant cells. Information on in vivo imagingmethods is summarized in Example 7.

Determine the Specificity and Sensitivity of LS838 in Detecting EarlyPanIN and PDAC Lesions:

Data show that LS838 identifies advanced PDAC tumors and microscopicPanIN3⁺ lesions. However, it is not yet known the earliest stage ofdisease that LS838 can differentiate from non-tumor tissue. This is animportant clinical question, as the ability to non-invasively detectearly PanIN lesions would allow for increased surveillance in theseindividuals without further major surgical procedures. In particular,the detection and differentiation of advanced lesions such as PanIN3 andPDAC from more indolent disease, i.e. PanIN1-2 and ductalhyperplasia/metaplasia, would inform more aggressive treatmentdecisions. Thus, the disease stages detected by LS838 will be defined.

Mouse models for PDAC, indolent and aggressive PanIN, and chronicpancreatitis will be used in these studies. While LS838 is visible inhistologic sections, this signal is significantly reduced during tissueprocessing for standard immunohistochemistry, making co-localizationwith cell type specific markers in tissue sections difficult. Toovercome this barrier, KPC-Y mice (p48-CRE/LSL-Kras^(G12D)/p53^(Flox/+);YFP+) will be employed. This model will allow the specific detection ofLS838⁺/YFP⁺ transformed cells even in very early PanIN lesions. UsingKPC-Y mice aged to 2, 3 or 4 months of age, LS838 signal intensity willbe assessed using a combination of non-invasive quantitative FMT (FIG.9) in vivo and high resolution ex vivo imaging of the pancreas to assessthe distribution of LS838 in these early stage tissues. UsingYFP-positivity to identify transformed cells (Kras^(G12D)+ cells), thespectrum of LS838 retention in premalignant and malignant cells will beassessed by flow cytometry. Additionally, co-localization of LS838 andYFP+ will be analyzed in frozen tissue sections, and fluorescenceintensity in individual PanIN-1, -2, -3 and PDAC lesions (usingMetaMorf) will be determined and compared to histology as the GoldStandard. Together, these data will determine at what stage of PDACprogression LS838 is selectively retained in pre-malignant cells andwhen disease is discernable by non-invasive imaging.

To determine if LS838 selective uptake and retention is increased asKras-transformed pancreas cells move from indolent to progressivedisease, pancreatitis-induced disease progression inp48-CRE/LSL-Kras^(G12D)/LSL-YFP mice will be analyzed. Without the lossof p53, the majority of these mice will have stable early stage PanINdisease that will not progress to PDAC. However in the context ofCaerulein induced pancreatitis, disease will progress stochastically.LS838 signal intensity will be assessed using a combination ofnon-invasive quantitative FMT and ex vivo imaging of the pancreas in2-month-old p48-CRE/LSL-Kras^(G12D)/LSL-YFP and control (p48-negative)mice treated with Caerulein (50 mg/kg×3/week) or vehicle for 1 and 3months. Pancreatic tissues from these mice will be analyzed by flowcytometry and immunofluorescence microscopy for LS838 in YFP+ cells, asdescribed above. Nine mice will be analyzed for each group at eachstage. These experiments will determine if LS838 selective uptake andretention is increased as transformed cells move from indolent toprogressive disease during pancreatitis.

Determine if Kras-Induced Oncogenic Transformation Leads to LS838Selective Uptake and Retention:

Activating mutations in Kras are present in >90% of pancreaticadenocarcinomas, but are often also found in indolent hyperplastic ordysplastic pancreas tissue. To determine if oncogenic transformation byactivated Kras drives malignant cell specific uptake and retention ofLS838, the effects of Kras mutation on LS838 retention in vitro will beassessed. To accomplish this goal, normal pancreatic ductal epithelialcells from LSL-KrasG12D mice will be isolated using standard protocols.To rearrange wild-type Kras into oncogenic Kras^(G12D), isolatedpancreatic epithelial cells will be infected with Adenovirus encodingCRE and GFP or GFP only (as control). About 48 h after infection, GFP+cells will be FACS sorted for use. The uptake and retention of LS838will be assessed in Kras^(G12D+) and negative pancreatic epithelialcells. The data will be compared to cell lines isolated from late stageKPC mice. Both imaging and flow cytometry will be used to determineuptake and retention every 3 h for 36 h. These data are importantbecause they will determine if oncogenetic transformation alone issufficient to induce specific LS838 uptake and retention. Directcorrelation will provide an indirect method to report the expressionlevel of Kras necessary to stimulate oncogenic processes in cells.

The sensitivity and specificity for detecting cancer and neoplasia willbe analyzed. The relative contrast of tumor to surrounding healthytissue will be measured for each tumor to determine specificity of themolecular probe and sensitivity of the endoscope. The relative contrastof tumor to surrounding healthy tissue will also be measured for eachtumor to determine specificity and sensitivity of the molecular probe.The statistical significance of tumor-specific contrast will be analyzedusing Student's t-test with alpha=0.05 and P<0.05 consideredsignificant. It is expected that LS838 will produce high sensitivity(>90%) and specificity (>90%) for PDAC and will distinguish theselesions from pancreatitis.

Kras expression may not correlate with the uptake of LS838. In thatcase, the results will indicate the earliest PanIN cell phenotypedetected by LS838. An alternative hypothesis is that the uptake of LS838may correlate with an increase in the proliferation state oftransforming pancreatic cells. In this case, the relationship betweenLS838 uptake and the metabolic status of tumors will be determined bycorrelating LS838 uptake with uptake of [¹⁸F]-2-fluoro-deoxyglucose, areporter of glucose metabolism, using PET.

Example 7. Determine the Accuracy of Detecting PDAC/PanIN in HumanPatient-Derived PDAC and Mouse Models that Recapitulate Different Stagesof PDAC

Genetic models of PDAC progression in mice as well as acute and chronicpancreatitis models will be used for this study. This model will be usedto assess the translation of findings using LS838 in mouse to humanmodels of PDAC. It is expected that LS838 will accurately characterizepancreatic lesions and potentially identify occult metastatic disease atthe time of surgery.

Determination of the Accuracy of Imaging PDAC and Chronic PancreatitisMouse Models Using LS838:

PDAC, premalignant neoplasia, and chronic pancreatitis models will beemployed in this study. The optimal injection dose to obtain the besttumor/normal tissue contrast will be determined. It is expected thattumors <0.5 mm diameter will be detected. LS838 and a nonspecificcontrol [LS838N: Cypate-cyclo(Tyr-Gly-Arg-Asp-Ser-Pro-_(D)Cys)-Lys-NH₂](SEQ ID NO:16), will be administered intravenously (i.v.) using 10 nmolof the molecular probe dissolved in PBS containing 2% mouse serumalbumin per 25 g mouse (this concentration was used in preliminarystudies, but will be varied to optimize dosage: 1, 5, 10, and 20 nmol/25g mouse). We will use KPC mice at 3 different stages of PDACdevelopment: (a) PanIN-1/2-1-2 months; PanIN-2/3-2-3 months; andadvanced PDAC→4 months. The animals will first be imaged longitudinallyand noninvasively with the fluorescence molecular tomography (FMT)system. A side view will be used to image the pancreas using the LICORplanar NIR imaging system. Non-invasive imaging will be performed at0.5, 1, 4, 8, 18, 24, 48, 72, and 96 h after injection to determine thelongitudinal retention of the agent in PDAC. Imaging will be stoppedwhen fluorescence in the tumor and adjacent pancreas are similar orindistinguishable by the imaging systems. Noninvasive FMT will first beused to image the mice at 1, 4, 8, 24, and 48 h post injection beforeexposing the pancreas by skin incision and gentle retraction with bluntdissection. Using a Karl Storz Image 1H3-Z color-NIR fluorescenceendoscope, endoscopy of the pancreas will be simulated to determine thedetection and delineation of pancreatic lesions. Acholangiopancreatoscope will be used to identify areas of highfluorescence intensity (FIG. 12), a feature that is useful forimage-guided surgery. Acquired images will be processed via thecontrolling software to measure the fluorescence intensity from areasidentified as tumor or normal. These values will be used to establishthresholds for tumor detection. Receiver Operating Characteristic curve(ROC) analysis will be used to determine the threshold fluorescencecontrast for detecting PDAC cells. Based on preliminary data, it isexpected that >20% NIR fluorescence in PDAC cells relative to theintensity in uninvolved pancreas will serve as an internal control todelineate this lesion. Suspicious areas, including highly fluorescentand non-fluorescent pancreatic tissues with and without obvious tumors,will be excised and snap-frozen for cryosectioning. Frozen tissues willbe examined by fluorescence microscopy and data will be referenced tohistopathology as the gold standard.

Determination of Biodistribution of the Molecular Probes:

A simple method for fluorescence-based biodistribution studies will beused. Briefly, after completing endoscopy at the time points indicatedabove, mice will be euthanized by cervical dislocation. Aliquots ofblood and all major organs (pancreas, heart, kidney, lung, spleen,stomach, intestine, muscle, kidney, adrenals, liver, skin, bone, andbrain) will be harvested, washed with PBS, dried and weighed. The organsand a small glass vial containing a known volume of blood will be imagedwith the LICOR NIR planar imaging system. Using a reference tissue model(a known concentration of the molecular probe is injected into similartissues from untreated mice) as fiducial markers, the relative uptake ofthe probe in various tissues will be determined. This approach willallow normalization of differences in the optical properties of tissue.The imaging system has software that calculates the mean fluorescencecount plus or minus standard error of mean within any chosen area on thefluorescence image. The relative uptake as percent fluorescence per gramtissue relative to the pancreas will be reported. Organs will beprocessed for histopathology. Tissue classification as PDAC/PanIN vs.pancreatitis by LS838 fluorescence will be compared with histopathologyto determine the diagnostic accuracy of our approach.

Determination of the Detection of Microscopic PDAC Using LS838-Aided NIRLaparoscopy to Improve the Diagnostic Yield of Pancreatic Biopsies:

A potential advantage of using LS838 is the potential to detectmicroscopic PDAC cells when visual inspection or white light is notcapable of identifying these lesions. LS838-aided biopsy of the pancreaswill be simulated by using early stage PDAC in the KPC mouse model, whena significant number of cells are in the PanIN-2/3 stage, as reported bythe KPC-Y model. Based on the point of highest contrast between PDAC anduninvolved pancreas as determined above, the NIR laparoscope will beutilized to identify PDAC cells, (as described above) to simulate tissuebiopsy (n=9). Resected tissue will be analyzed and scored byhistopathology. It is expected that the NIR fluorescence-aided tissuesample collection will improve the yield of pancreatic biopsy withaccuracy approaching 100% relative to conventional biopsy.

Determination of the Distribution and Uptake of New Molecular ProbesSynthesized in Example 5 by PDAC:

New compounds will be prepared as described in Example 5. When theybecome available, the optimized imaging time point and injected dose ofLS838 will be used to determine the in vivo biodistribution andretention of the new compounds. Specifically, these parameters will bedetermined for LS276 and LS288 dye-labeled analogues of LS838 (role ofdye in retention), as well as for two molecular probes from the modifiedpeptide analogues of LS838 based on the in vitro results (role ofpeptide in retention). Thus, in addition to LS838, four new molecularprobes will be imaged and the data compared with those of LS838. Theanimals will be imaged at 1, 4, and 24 h post injection before excisingtheir organs for biodistribution studies, as described above. It isexpected that the in vivo results will confirm the findings of the cellstudies. Together, the information can be used to optimize thestructural features of LS838 for rapid uptake and retention in tumors,with the highest contrast between tumor and uninvolved pancreas within 4h post injection.

Determination of the Potential Use of LS838 Fluorescence to Detect PDACfrom Human Patients:

The PCBC SCC has established >30 PDAC lines from resected pancreaticcancer specimens and has developed heterotopic and orthotopic PDXs(Patient Derived Xenografts) in NOD-SCID mice. PDXs and theirderivatives are attractive model systems. PDXs are typically generatedby subcutaneous implantation of human tumors directly from patients (viabiopsy or surgery) into immunodeficient mice (generally mice based onthe non-obese diabetic—severe combined immunodeficient, or NOD-SCID,background). Tumors can then be passaged serially in NOD-SCID mice viaheterotopic (subcutaneously) or orthotopic (into the originating organ)transplantation and used as a model system for various aspects of cancerresearch. Some advantages of PDXs and their derivatives include: (1)their human tumor origin, (2) the ability to correlate findings in PDXmodels with the clinical outcomes of the patients from which the PDXsand derivatives were established, and (3) the potential to use PDXs todevelop translational oncology model systems to study, for example,metastatic biology and to evaluate novel therapeutics.

27 mice each of heterotopic and orthotopic PDX bearing NOD-SCID micefrom the PCBC SCC will be obtained for this study. The accuracy ofidentifying PDX in both models (n=9 for each model) will be determinedas described above using LS838 and the non-PDAX specific controlcompound, LS838N. Imaging will commence when tumor size reaches ≥5 mm(determined by caliper measurement for the heterotopic model andestablished growth rate for the orthotopic model). After administeringthe imaging agent (10 nmol/20 g mouse), longitudinal FMT imaging will beperformed at 0.5, 1, 4, 8, 18, and 24 h. At 24 h, laparoscopy will beconducted as described above and the animal will be euthanized forbiodistribution analysis and histopathology. Because LS838 is intendedto be used in patients scheduled to undergo surgery or exploratorylaparoscopy, another set of 9 mice will be used for laparoscopy andbiodistribution/histology to simulate clinical settings. A similar studywill be conducted with LS838N. Data will be processed and analyzed asdescried above. It is expected that LS838 will have similar accuracy indetecting PDX as mouse PDAC. The results will provide preclinical datato determine potential translation of the compound in humans. Thesensitivity and specificity (accuracy) will be calculated as well aspositive and negative predictive values of PDAC/PanIN detection usingLS838 based on the histology data.

Data strongly supports the feasibility of using LS838 to delineate PDACand premalignant neoplasia from pancreatitis. LS838 fluorescence may notcorrelate with presence of disease determined by histology. In thiscase, YFP fluorescence from the KPC-YFP model will be used to determineearly PDAC lesions. The quantitative accuracy of FMT system and NIRlaparoscope may be affected by differences in tissue optical properties.Since LS838 has a tyrosine residue, the compound could be radiolabeledwith ¹²⁵I for SPECT imaging and biodistribution studies (note thatthyroid uptake of iodine will be considered in data analysis).

The methodologies described herein result in the following, non-limitinginnovations:

1: A novel imaging agent, LS838, has been developed which detects PDACand PanIN 2/3 lesions with high accuracy. A new uptake mechanisminvolves facilitated uptake mediated by the energy needs of thesemetabolically active cells, followed by intracellular trapping under thehighly reducing environment of these cells.

2: Application of LS838 to distinguish PDAC and transforming PanIN fromchronic pancreatitis with high accuracy represents significant progressin the management of this disease.

3: The NIR fluorescence allows detection of microscopic lesions, whichare not visible with current clinical imaging techniques. In addition,the fluorescence of LS838 is brighter than LS301, allowing us to usesmaller amounts of the material to achieve the same uptake kinetics asLS301.

4: LS838 can be radiolabeled at a tyrosine residue for combinedintravital fluorescence microscopy and noninvasive PDAC imaging. UnlikeLS301, the tyrosine within LS838 allows the labeling of LS838 withradionuclides such as fluorine-18, iodine-123, I-124, I-125, and I-131.This allows the imaging of cancer in the human body noninvasively usingnuclear imaging methods, and then the use of optical methods to guidetissue biopsy, surgery, and assessment of surgical margins. Thiscombination of noninvasive and invasive methods opens new opportunityfor the use of this compound. The placement of the tyrosine is importantin the retention of LS838 in tumors.

5: Conjugation of chemotherapeutics to the free carboxylic acid group ofLS838 will allow highly selective treatment of PDAC with minimaloff-target effect on the healthy pancreatic cells.

6: LS838 selectively remains in diverse tumors without significant lossof fluorescence over time.

7: The high specificity of LS838 for cancer cells in the presence ofhealthy white blood cells creates a unique opportunity to use the sameagent for detecting circulating tumor cells (CTCs) without resorting toadditional tagging steps with multiple expensive antibodies.

What is claimed is:
 1. A compound having the formula:R¹—[X¹ _(m)—R-D-X² _(p)]_(n)—Y—R² wherein: R¹ is a carbocyanine dyeselected from Cypate (cypate 4), LS288, LS798, LS276, LS843, Cypate 3,and Cypate 2; R² is selected from a treatment agent, hydrogen, hydroxyl,NH₂, hydrocarbyl, and substituted hydrocarbyl; wherein the treatmentagent selected from daunorubicin, adriamycin, paclitaxel, docetaxel,vinblastine, vincristine, vinorelbine, 5-fluorouracil, capecitabine,6-mercaptopurine, methotrexate, gemcitabine, cytarabine, fludarabine,pemetrexed, cytosine arabinoside, methotrexate, aminopterin, busulfan,cisplatin, carboplatin, chlorambucil, cyclophosphamide, ifosfamide,dacarbazine, mechlorethamine, melphalan, temozolomide, carmustine,lomustine, daunorubicin, doxorubicin, epirubicin, idarubicin,mitoxantrone, topotecan, irinotecan, etoposide, teniposide, cytotoxins,macromycin, taxol, cholchicine, VEGF inhibitors, and anti-VEGFantibodies; [X¹ _(m)—R-D-X² _(p)]_(n)—Y together form a linear or cyclicpeptide selected from the group consisting of SEQ ID NO: [X¹ _(m)-R-D-X²_(p)]_(n)Y  8 [_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr  9[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 10[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys 11[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 12[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 17Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr 18Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr 19Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 20Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr-Lys 21Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 22Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr 23Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr

and a dash (-) represent a covalent bond.
 2. The compound of claim 1,further comprising a polyethylene glycol moiety conjugated to thecarbocyanine dye.
 3. The compound of claim 1, wherein the Y isradiolabeled.
 4. The compound of claim 3, wherein the radiolabel isfluorine or iodine radionuclide.
 5. The compound of claim 1, furthercomprising a linker, L¹, that conjugates R¹ to X¹ and a linker, L², thatconjugates R² to Y.
 6. The compound of claim 5, wherein the linker isselected from an amino acid residue, a hydrocarbyl and a substitutedhydrocarbyl.
 7. A compound having formula (II):

wherein: R³ is selected from daunorubicin, adriamycin, paclitaxel,docetaxel, vinblastine, vincristine, vinorelbine, 5-fluorouracil,capecitabine, 6-mercaptopurine, methotrexate, gemcitabine, cytarabine,fludarabine, pemetrexed, cytosine arabinoside, methotrexate,aminopterin, busulfan, cisplatin, carboplatin, chlorambucil,cyclophosphamide, ifosfamide, dacarbazine, mechlorethamine, melphalan,temozolomide, carmustine, lomustine, daunorubicin, doxorubicin,epirubicin, idarubicin, mitoxantrone, topotecan, irinotecan, etoposide,teniposide, cytotoxins, macromycin, taxol, cholchicine, VEGF inhibitors,and anti-VEGF antibodies; and R⁴ is selected from the group consistingof: SEQ  ID NO: R⁴  8 CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Lys-Tyr-OH 9 CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 10CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-Lys-OH 11CONH-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 12CONH-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr-OH 13CONH-[Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 14CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-Cys]-Tyr-OH 15CONH-[_(D)Cys-Arg-Gly-Asp-Ser-Pro-_(D)Cys]-Tyr-OH 17CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-Tyr- OH 18CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- OH 19CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 20CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-Cys]-_(D)Tyr- Lys-OH 21CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 22CONH-Gly-[Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-Tyr- OH 23CONH-Gly-[_(D)Cys-Gly-Arg-Asp-Ser-Pro-_(D)Cys]-_(D)Tyr- OH.


8. The compound of claim 7, wherein R⁴ is selected from SEQ ID NOS 18,19, 20, 21, and
 23. 9. The compound of claim 7, wherein one or moreamino acid residues are inserted prior to or after the Tyr of R⁴. 10.The compound of claim 9, wherein a Lys is inserted after the Tyr. 11.The compound of claim 7, wherein the Tyr is halogenated.
 12. Thecompound of claim 11, wherein the halogen is a radioisotope selectedfrom ¹⁸F, ⁷⁵Br, ⁷⁷Br, ¹²²I, ¹²³I, ¹²⁴I, ¹²⁵I, ¹²⁹I, ¹³¹I, and ²¹¹At. 13.The compound of claim 1, wherein [X¹ _(m)—R-D-X² _(p)]_(n)—Y is SEQ IDNO:
 9. 14. The compound of claim 1, wherein [X¹ _(m)—R-D-X² _(p)]_(n)—Yis SEQ ID NO: 11.